Provider Demographics
NPI:1225817018
Name:BECK, SHANA DANIELLE
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:DANIELLE
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2774
Mailing Address - Country:US
Mailing Address - Phone:606-278-9557
Mailing Address - Fax:
Practice Address - Street 1:1220 BROADCASTING RD STE 203
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3221
Practice Address - Country:US
Practice Address - Phone:606-278-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health