Provider Demographics
NPI:1497435317
Name:BECKETT, SEAN (MA, LAC, NCC, CTP)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BECKETT
Suffix:
Gender:M
Credentials:MA, LAC, NCC, CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 QUAKERBRIDGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1200
Mailing Address - Country:US
Mailing Address - Phone:609-249-4645
Mailing Address - Fax:
Practice Address - Street 1:3535 QUAKERBRIDGE RD STE 300
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1200
Practice Address - Country:US
Practice Address - Phone:609-249-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00730800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health