Provider Demographics
NPI:1487214243
Name:BECKLEY, SKYE
Entity Type:Individual
Prefix:
First Name:SKYE
Middle Name:
Last Name:BECKLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 HIGHLANDS LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-3629
Mailing Address - Country:US
Mailing Address - Phone:302-454-3424
Mailing Address - Fax:
Practice Address - Street 1:2815 HIGHLANDS LN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-3629
Practice Address - Country:US
Practice Address - Phone:302-454-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE90306103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool