Provider Demographics
NPI:1902399447
Name:BECK, MICHAEL LOUIS (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:LOUIS
Last Name:BECK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E 40TH ST APT 2X
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2016
Mailing Address - Country:US
Mailing Address - Phone:212-799-6382
Mailing Address - Fax:
Practice Address - Street 1:305 E 40TH ST
Practice Address - Street 2:APT 2X
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2016
Practice Address - Country:US
Practice Address - Phone:212-799-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-10
Last Update Date:2018-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0818631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty