Organization
IMPACT PSYCHOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ECKERMAN PSYD (CLINICAL PSYCHOLOGIST)
(651) 204-4034
Entity
Organization
Contact information
Practice address
724 BIELENBERG DRIVE, SUITE 4, WOODBURY, MN 55125-5512
(651) 204-4034
Mailing address
6958 W 84TH ST, MINNEAPOLIS, MN 55438-1159
(651) 235-5170
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LP5825
MN
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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