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Individual
GORDON ECKROTH
Active
Individual
GORDON ECKROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW/BCD
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0186
ND
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05382
BCBS OF ND
—
01
—
N5382
RR MEDICARE
—
Enumeration date
06/29/2006
Last updated
08/15/2013
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