Provider Demographics
NPI:1619183704
Name:BECKER, MICHAEL SCOTT (MS, MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:BECKER
Suffix:
Gender:M
Credentials:MS, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-2720
Mailing Address - Country:US
Mailing Address - Phone:402-362-4990
Mailing Address - Fax:402-362-0113
Practice Address - Street 1:1225 E 10TH ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-2720
Practice Address - Country:US
Practice Address - Phone:402-362-4990
Practice Address - Fax:402-362-0113
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical