Provider Demographics
NPI:1417171950
Name:BECK COUNSELING AND COACHING LLC
Entity Type:Organization
Organization Name:BECK COUNSELING AND COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:UNTERNAHRER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LCSW
Authorized Official - Phone:574-535-2325
Mailing Address - Street 1:109 E CLINTON ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-3233
Mailing Address - Country:US
Mailing Address - Phone:574-535-2325
Mailing Address - Fax:574-533-5433
Practice Address - Street 1:109 E CLINTON ST
Practice Address - Street 2:STE 10
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-3233
Practice Address - Country:US
Practice Address - Phone:574-535-2325
Practice Address - Fax:574-533-5433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100461860Medicaid
IN100461860Medicaid