Provider Demographics
NPI:1366616120
Name:BECKER, LOUIS CHARLES (LCSW)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:CHARLES
Last Name:BECKER
Suffix:
Gender:M
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:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:CEDAR BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08018-0315
Mailing Address - Country:US
Mailing Address - Phone:609-567-8484
Mailing Address - Fax:609-567-0999
Practice Address - Street 1:777 PROFESSIONAL CTR
Practice Address - Street 2:SUITE B-1
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2029
Practice Address - Country:US
Practice Address - Phone:609-567-8484
Practice Address - Fax:609-567-0999
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046429001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical