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Individual

STEPHANIE R BECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC,LSW

Contact information

Practice address
145 LISBON ST, SUITE 606, LEWISTON, ME 04240-7235
(207) 939-1650
Mailing address
145 LISBON ST, SUITE 606, LEWISTON, ME 04240-7235
(207) 939-1650

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC4141
ME
104100000X
Social Worker
LSX10633
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
201215
ANTHEM
ME
05
432552599
ME
Enumeration date
06/12/2008
Last updated
07/14/2008
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