Provider Demographics
NPI:1669701652
Name:BECK, KATHLEEN ANN (MSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:BECK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3666 N MILLER RD
Mailing Address - Street 2:SIUTE 113
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-4599
Mailing Address - Country:US
Mailing Address - Phone:480-941-3477
Mailing Address - Fax:
Practice Address - Street 1:3666 N MILLER RD
Practice Address - Street 2:SIUTE 113
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-4599
Practice Address - Country:US
Practice Address - Phone:480-941-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW0331106H00000X
AZMFT0266106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist