Provider Demographics
NPI:1669784468
Name:BECK, KELLEY D (PHD)
Entity type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:D
Last Name:BECK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 S COLLEGE ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-5505
Mailing Address - Country:US
Mailing Address - Phone:214-491-1933
Mailing Address - Fax:214-491-1934
Practice Address - Street 1:808 S COLLEGE ST
Practice Address - Street 2:SUITE 309
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-5505
Practice Address - Country:US
Practice Address - Phone:214-491-1933
Practice Address - Fax:214-491-1934
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34341103G00000X, 103TC0700X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth