Provider Demographics
NPI:1295897494
Name:BECKES, NANCY KAY S (LICSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:KAY S
Last Name:BECKES
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 6TH ST E
Mailing Address - Street 2:#3403
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1991
Mailing Address - Country:US
Mailing Address - Phone:651-291-2475
Mailing Address - Fax:
Practice Address - Street 1:1711 COUNTY ROAD B W
Practice Address - Street 2:200S
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-4057
Practice Address - Country:US
Practice Address - Phone:651-635-0477
Practice Address - Fax:651-635-0455
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN87821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical