Provider Demographics
NPI:1528007614
Name:SUZANNE BECKER, LCSW, PC
Entity Type:Organization
Organization Name:SUZANNE BECKER, LCSW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:970-441-0026
Mailing Address - Street 1:306 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723-2512
Mailing Address - Country:US
Mailing Address - Phone:970-441-0026
Mailing Address - Fax:
Practice Address - Street 1:306 CURTIS ST
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723-2512
Practice Address - Country:US
Practice Address - Phone:970-441-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty