Provider Demographics
NPI:1003985987
Name:BECK, KAREN DIANE (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:DIANE
Last Name:BECK
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 NORTH ADAMS STREET
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-6137
Mailing Address - Country:US
Mailing Address - Phone:850-681-8511
Mailing Address - Fax:850-681-8512
Practice Address - Street 1:1228 NORTH ADAMS STREET
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-6137
Practice Address - Country:US
Practice Address - Phone:850-681-8511
Practice Address - Fax:850-681-8512
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z1542OtherBCBS
S14554Medicare UPIN