Provider Demographics
NPI:1831246933
Name:BECK, ROBERT N (LCSW)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:N
Last Name:BECK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 WHEELER CT UNIT F
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-1494
Mailing Address - Country:US
Mailing Address - Phone:608-249-6068
Mailing Address - Fax:
Practice Address - Street 1:1434 WHEELER CT UNIT F
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-1494
Practice Address - Country:US
Practice Address - Phone:608-249-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6838-1231041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40989500Medicaid
WI40989500Medicaid