Provider Demographics
NPI:1083301824
Name:BECKLEY-WATSON LLC
Entity Type:Organization
Organization Name:BECKLEY-WATSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:BECKLEY-WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:740-277-1541
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:43155-0047
Mailing Address - Country:US
Mailing Address - Phone:740-277-1541
Mailing Address - Fax:
Practice Address - Street 1:123 S BROAD ST STE 206
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4304
Practice Address - Country:US
Practice Address - Phone:740-277-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)