Individual
JACQUELINE FEDASH BECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
154 BEACON DR, SUITE I, WINTERVILLE, NC 28590-7860
(252) 353-1114
(252) 353-1119
Mailing address
154 BEACON DR, SUITE I, WINTERVILLE, NC 28590-7860
(252) 353-1114
(252) 353-1119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7076
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104243
—
NC
Enumeration date
06/26/2009
Last updated
11/03/2009
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