Provider Demographics
NPI:1609030295
Name:BECKER PSYCHOLOGICAL SERVICES INC.
Entity Type:Organization
Organization Name:BECKER PSYCHOLOGICAL SERVICES INC.
Other - Org Name:NOBLE INVESTMENT GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING/OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:142-725-8062
Mailing Address - Street 1:804 PERSHING DR STE 4
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4436
Mailing Address - Country:US
Mailing Address - Phone:301-385-8830
Mailing Address - Fax:301-588-3087
Practice Address - Street 1:804 PERSHING DR
Practice Address - Street 2:SUITE 004
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-588-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04379103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD064639300Medicaid