Provider Demographics
NPI:1619734167
Name:BECKFORD, VONRIA
Entity Type:Individual
Prefix:
First Name:VONRIA
Middle Name:
Last Name:BECKFORD
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 1:5932 WESTFALL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6733
Mailing Address - Country:US
Mailing Address - Phone:561-951-8664
Mailing Address - Fax:561-516-7398
Practice Address - Street 1:5932 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33463-6733
Practice Address - Country:US
Practice Address - Phone:561-951-8664
Practice Address - Fax:561-516-7398
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH21862101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor