Provider Demographics
NPI:1548933542
Name:EYTCHESON, JADE LYNN (LMHC)
Entity type:Individual
Prefix:
First Name:JADE
Middle Name:LYNN
Last Name:EYTCHESON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8670 BROADWAY STE CA
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7034
Mailing Address - Country:US
Mailing Address - Phone:219-895-4575
Mailing Address - Fax:219-472-1099
Practice Address - Street 1:8670 BROADWAY STE CA
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7034
Practice Address - Country:US
Practice Address - Phone:219-895-4575
Practice Address - Fax:219-472-1099
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004020A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health