Provider Demographics
NPI:1114633799
Name:BECOAT-ECLOU, TAMMY K (LCSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:K
Last Name:BECOAT-ECLOU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BULKHEAD PL
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-5777
Mailing Address - Country:US
Mailing Address - Phone:804-338-1297
Mailing Address - Fax:
Practice Address - Street 1:3700 FESTIVAL PARK PLZ
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-4415
Practice Address - Country:US
Practice Address - Phone:804-314-1187
Practice Address - Fax:804-562-5135
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040113611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical