Provider Demographics
NPI:1336685635
Name:BECKNER, DYLAN (LCSW)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:BECKNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DYLAN
Other - Middle Name:
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 CARDINAL PARK DR SE STE 104A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4448
Mailing Address - Country:US
Mailing Address - Phone:508-364-4233
Mailing Address - Fax:
Practice Address - Street 1:2 CARDINAL PARK DR SE STE 104A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4448
Practice Address - Country:US
Practice Address - Phone:508-364-4233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-10
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040119861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical