Individual
GINA M. BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.S.W.
Contact information
Practice address
6451 MCCALL ST STE D, BONNERS FERRY, ID 83805-8525
(208) 304-2657
(208) 215-2473
Mailing address
6451 MCCALL ST STE D, BONNERS FERRY, ID 83805-8525
(208) 304-2657
(208) 215-2473
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCS 18467
CA
1041C0700X
Clinical Social Worker
Primary
LCSW 30443
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154612216
MEDICARE
—
05
—
1245528082
—
ID
Enumeration date
04/25/2011
Last updated
10/31/2022
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