Provider Demographics
NPI:1265130686
Name:BECKFORD, JEANNETTE ARIS (LMHC)
Entity type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:ARIS
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8741 LIMBERLOST CT
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8830
Mailing Address - Country:US
Mailing Address - Phone:317-205-5009
Mailing Address - Fax:
Practice Address - Street 1:2626 E 46TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2380
Practice Address - Country:US
Practice Address - Phone:317-475-9066
Practice Address - Fax:317-510-9579
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001600A101YM0800X
IN39005173A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN88001600AOtherINDIANA PROFESSIONAL LICENSING AGENCY
IN1104622847OtherANTHEM PTAN