Provider Demographics
NPI:1316959422
Name:BECK, SUSAN L (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:L
Last Name:BECK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 CANTRELL AVE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3248
Mailing Address - Country:US
Mailing Address - Phone:540-564-5960
Mailing Address - Fax:540-433-4338
Practice Address - Street 1:752 OTT ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3214
Practice Address - Country:US
Practice Address - Phone:540-564-5960
Practice Address - Fax:540-433-4338
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040060651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA252369OtherCOMPSYCH PROVIDER NUMBER
VAC05754OtherMEDICARE GROUP NUMBER
VA178818OtherANTHEM PROVIDER NUMBER
VA010177863Medicaid
VA2239706OtherCIGNA PROVIDER NUMBER
VA084453MOtherSENTARA PROVIDER NUMBER
VA1164637518OtherGROUP NPI NUMBER
VA007512R54Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER