Provider Demographics
NPI:1467515510
Name:BECK, JUDY K (MA, LPCC)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:K
Last Name:BECK
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W APACHE ST BLDG 16
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3886
Mailing Address - Country:US
Mailing Address - Phone:505-436-1114
Mailing Address - Fax:505-806-7462
Practice Address - Street 1:1200 W APACHE ST BLDG 16
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-3886
Practice Address - Country:US
Practice Address - Phone:505-436-1114
Practice Address - Fax:505-806-7462
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0076041101YP2500X, 101YM0800X
NM270679103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00JM82OtherBLUE CROSS BLUE SHIELD
NM49536290Medicaid
NM67577725Medicaid