Provider Demographics
NPI:1114968864
Name:BECKING, LANA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LANA
Middle Name:
Last Name:BECKING
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 1:155 W LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72529-5338
Mailing Address - Country:US
Mailing Address - Phone:870-257-3292
Mailing Address - Fax:870-257-3292
Practice Address - Street 1:714A ASH FLAT DR.
Practice Address - Street 2:
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513
Practice Address - Country:US
Practice Address - Phone:866-533-1761
Practice Address - Fax:870-994-7868
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0058551041C0700X
AR2098C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO494716616Medicaid