Provider Demographics
NPI:1700835972
Name:BECK, NIELS C (PHD)
Entity Type:Individual
Prefix:
First Name:NIELS
Middle Name:C
Last Name:BECK
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-8913
Practice Address - Fax:573-884-1070
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPY00091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO3546OtherBLUE SHIELD
MO6142526OtherUNITED HEALTHCARE
MO3546OtherBLUE CHOICE
MO126615OtherHEALTHLINK
MOP00081812Medicare PIN
MO126615OtherHEALTHLINK
MO3546OtherBLUE SHIELD