Provider Demographics
NPI:1891862165
Name:BECKI A BOWDITCH INC
Entity Type:Organization
Organization Name:BECKI A BOWDITCH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BECKI
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOWDITCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW ACSW RPT S
Authorized Official - Phone:755-446-9898
Mailing Address - Street 1:2201 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904
Mailing Address - Country:US
Mailing Address - Phone:765-446-9898
Mailing Address - Fax:765-446-9424
Practice Address - Street 1:2201 FERRY STREET
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904
Practice Address - Country:US
Practice Address - Phone:765-446-9898
Practice Address - Fax:765-446-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002352A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN140860AMedicare ID - Type Unspecified