Provider Demographics
NPI:1558347658
Name:BECK, JUDITH B (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:B
Last Name:BECK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 MAPLE DELL STE 3
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-2953
Mailing Address - Country:US
Mailing Address - Phone:518-581-8699
Mailing Address - Fax:
Practice Address - Street 1:15 MAPLE DELL STE 3
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2953
Practice Address - Country:US
Practice Address - Phone:518-581-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0609921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNG6291OtherBLUE CROSS
NY000407497001OtherBLUE SHIELD/HEALTHNOW
NY000407497001OtherBLUE SHIELD/HEALTHNOW