Provider Demographics
NPI:1467714196
Name:BECKETT, JOAN THERESA (LMHC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:THERESA
Last Name:BECKETT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PARDONS WOOD LN
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1446
Mailing Address - Country:US
Mailing Address - Phone:401-885-5179
Mailing Address - Fax:
Practice Address - Street 1:1130 TEN ROD RD
Practice Address - Street 2:F 206
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4161
Practice Address - Country:US
Practice Address - Phone:401-741-5179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health