Provider Demographics
NPI:1851832422
Name:BECK, CASSIE (N/A)
Entity Type:Individual
Prefix:MS
First Name:CASSIE
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 SHERRIS WAY
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-2012
Mailing Address - Country:US
Mailing Address - Phone:301-800-8558
Mailing Address - Fax:
Practice Address - Street 1:119 SHERRIS WAY
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-2012
Practice Address - Country:US
Practice Address - Phone:301-800-8558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician