Provider Demographics
NPI:1215642541
Name:BECERRA RIVERA, VERONICA LYNN (LCPC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:LYNN
Last Name:BECERRA RIVERA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 SINGER RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-2101
Mailing Address - Country:US
Mailing Address - Phone:443-390-9525
Mailing Address - Fax:
Practice Address - Street 1:1502 SINGER RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-2101
Practice Address - Country:US
Practice Address - Phone:443-390-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-20
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC15799101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor