Provider Demographics
NPI:1831249424
Name:BECKERMAN, NANCY (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BECKERMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 N GATE RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-3105
Mailing Address - Country:US
Mailing Address - Phone:973-543-1930
Mailing Address - Fax:973-543-1936
Practice Address - Street 1:248 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1210
Practice Address - Country:US
Practice Address - Phone:973-377-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC003589001041C0700X
NJ37F100102000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC00358900OtherSOCIAL WORKER LICENSE
NJ44SC00358900OtherSOCIAL WORKER LICENSE