Provider Demographics
NPI:1225642267
Name:BECKLEY, DOROTHY (LPC)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:BECKLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 N HUMPHREYS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3070
Mailing Address - Country:US
Mailing Address - Phone:928-864-5024
Mailing Address - Fax:
Practice Address - Street 1:624 N HUMPHREYS ST STE 1
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3070
Practice Address - Country:US
Practice Address - Phone:928-864-5024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-19200101YP2500X, 101YM0800X
AZ16885101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health