Provider Demographics
NPI:1518383561
Name:BECKER, CONNIE
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 WEST ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120
Mailing Address - Country:US
Mailing Address - Phone:412-461-4100
Mailing Address - Fax:
Practice Address - Street 1:1800 WEST ST
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120
Practice Address - Country:US
Practice Address - Phone:412-461-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-14
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker