Provider Demographics
NPI:1780040022
Name:BECK, DOLORES IRENE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DOLORES
Middle Name:IRENE
Last Name:BECK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S SPRUCE STREET
Mailing Address - Street 2:PO BOX 611
Mailing Address - City:WALLOWA
Mailing Address - State:OR
Mailing Address - Zip Code:97885
Mailing Address - Country:US
Mailing Address - Phone:541-398-1001
Mailing Address - Fax:541-426-3035
Practice Address - Street 1:207 SW 1ST STREET
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:OR
Practice Address - Zip Code:97828
Practice Address - Country:US
Practice Address - Phone:541-426-4524
Practice Address - Fax:541-426-3035
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6773101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor