Provider Demographics
NPI:1689938185
Name:BECK, SPENCER T (PSY D)
Entity Type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:T
Last Name:BECK
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15661 W DEVONSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-7775
Mailing Address - Country:US
Mailing Address - Phone:480-234-8205
Mailing Address - Fax:
Practice Address - Street 1:15661 W DEVONSHIRE AVE
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-7775
Practice Address - Country:US
Practice Address - Phone:480-234-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3667103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical