Provider Demographics
NPI:1386688208
Name:BECK, BONNIE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:A
Last Name:BECK
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 1:808 W END AVE
Mailing Address - Street 2:#301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5369
Mailing Address - Country:US
Mailing Address - Phone:212-222-4450
Mailing Address - Fax:212-246-0209
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:#501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3736
Practice Address - Country:US
Practice Address - Phone:212-246-0209
Practice Address - Fax:212-246-0209
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0162061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical