Provider Demographics
NPI:1083921985
Name:BECKER, NEIL (LCSW)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7362 WOODMONT CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3209
Mailing Address - Country:US
Mailing Address - Phone:203-247-5902
Mailing Address - Fax:
Practice Address - Street 1:247 MAIN ST
Practice Address - Street 2:UNIT 201
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2332
Practice Address - Country:US
Practice Address - Phone:203-247-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT87011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical