| Doctor Name: | MRS. SUSAN G ECKBERG |
| NPI Number: | 1669566261 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSW |
| License Number: | LCSW940 |
| Business Practice Address: | 238 Brookley Avenue Bldg 1300, Ste 259 Bolling Afb, DC - 200320101 |
| Business Phone Number: | 2024046502 |
| Business Fax Number: | 2024042911 |
| Mailing Address: | P.o. Box 19079, ALEXANDRIA |
| State: | VA |
| Postal Code: | 22320 |
| Phone Number: | 7035188388 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCSW940 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |