Provider Demographics
NPI:1801014154
Name:BECKNER, SYLVIA TERRY (MS)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:TERRY
Last Name:BECKNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:SYLVIA
Other - Middle Name:TERRY
Other - Last Name:BERGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:668 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-8945
Mailing Address - Country:US
Mailing Address - Phone:828-479-8223
Mailing Address - Fax:828-479-0649
Practice Address - Street 1:668 WHITE OAK ROAD
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28771
Practice Address - Country:US
Practice Address - Phone:828-735-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNCLPC 2132101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103190Medicaid