Individual
KIMBERLY BECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1002 N MULBERRY ST STE 100, ELIZABETHTOWN, KY 42701-2037
(207) 307-3276
Mailing address
589 RUE LA GRANDE, ELIZABETHTOWN, KY 42701-3135
(270) 307-3672
(253) 681-0825
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000495963
ANTHEM
KY
01
—
11574939
CAQH
—
05
—
30605018
—
KY
Enumeration date
06/03/2006
Last updated
10/09/2024
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