Provider Demographics
NPI:1528563103
Name:BECKMAN, LINDA MARIE
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:BECKMAN
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 1:11670 OLD NATIONAL PIKE STE 103
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6123
Mailing Address - Country:US
Mailing Address - Phone:130-186-5222
Mailing Address - Fax:
Practice Address - Street 1:11670 OLD NATIONAL PIKE STE 103
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6123
Practice Address - Country:US
Practice Address - Phone:130-186-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8483101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health