Provider Demographics
NPI:1255622379
Name:MICHAEL S. BECKER, PC
Entity type:Organization
Organization Name:MICHAEL S. BECKER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MSW, LCSW
Authorized Official - Phone:402-363-8774
Mailing Address - Street 1:942 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-1218
Mailing Address - Country:US
Mailing Address - Phone:402-759-3802
Mailing Address - Fax:402-759-3803
Practice Address - Street 1:942 N 13TH ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-1218
Practice Address - Country:US
Practice Address - Phone:402-759-3802
Practice Address - Fax:402-759-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-23
Last Update Date:2011-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE15511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025872800Medicaid
NE10025862200Medicaid