Provider Demographics
NPI:1154680809
Name:BECKER, MICHELE LYNN (MSW)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYNN
Last Name:BECKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 PERRY HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-2194
Mailing Address - Country:US
Mailing Address - Phone:129-989-0104
Mailing Address - Fax:412-998-9010
Practice Address - Street 1:1003 PERRY HWY STE 205
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2194
Practice Address - Country:US
Practice Address - Phone:412-998-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 104100000X
PACW0204361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171400000XOther Service ProvidersHealth & Wellness Coach
No104100000XBehavioral Health & Social Service ProvidersSocial Worker