Provider Demographics
NPI:1861917692
Name:SCHECHTER, ELIOT THEODORE (LPC)
Entity type:Individual
Prefix:
First Name:ELIOT
Middle Name:THEODORE
Last Name:SCHECHTER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-5113
Mailing Address - Country:US
Mailing Address - Phone:210-542-7834
Mailing Address - Fax:
Practice Address - Street 1:1347 FULTON AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-5113
Practice Address - Country:US
Practice Address - Phone:210-542-7834
Practice Address - Fax:210-735-9436
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-14
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3790800-001Medicaid
TX3790800-002Medicaid