Provider Demographics
NPI:1447564521
Name:BECKER, JENNIFER PERI (MS, LCMHCS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:PERI
Last Name:BECKER
Suffix:
Gender:F
Credentials:MS, LCMHCS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:PERI
Other - Last Name:BECKER-ROSENBLUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LCMHCS
Mailing Address - Street 1:910 N ELM STREET
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401
Mailing Address - Country:US
Mailing Address - Phone:336-365-6867
Mailing Address - Fax:336-450-4318
Practice Address - Street 1:1027 ARNOLD STREET
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-365-6867
Practice Address - Fax:336-450-4318
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8148101YM0800X
NCS8148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health