Provider Demographics
NPI:1346309283
Name:BECK, JUSTIN CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:CHRISTOPHER
Last Name:BECK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 POCONO RD
Mailing Address - Street 2:C O SAINT CLARE'S HOSPITAL
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2956
Mailing Address - Country:US
Mailing Address - Phone:973-299-5474
Mailing Address - Fax:973-316-1839
Practice Address - Street 1:4 POCONO RD
Practice Address - Street 2:C O SAINT CLARE'S HOSPITAL
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2956
Practice Address - Country:US
Practice Address - Phone:973-299-5474
Practice Address - Fax:973-316-1839
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046587001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
042991BD2Medicare ID - Type Unspecified