Provider Demographics
NPI:1619213923
Name:BECKERMAN, ASHLEY (LMFT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BECKERMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:643 W MAIN ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-3954
Mailing Address - Country:US
Mailing Address - Phone:860-395-8522
Mailing Address - Fax:
Practice Address - Street 1:643 W MAIN ST APT 3E
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3954
Practice Address - Country:US
Practice Address - Phone:860-395-8522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0002534106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist