Provider Demographics
NPI:1790101707
Name:BECKER, ALLISON FLYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FLYNN
Last Name:BECKER
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 1:114 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1806
Mailing Address - Country:US
Mailing Address - Phone:570-977-2344
Mailing Address - Fax:
Practice Address - Street 1:114 S 2ND ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1806
Practice Address - Country:US
Practice Address - Phone:570-977-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-14
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055772001041C0700X
PACW0178581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical