Provider Demographics
NPI:1386116176
Name:BECK, JENNIFER (LMFT, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E 2ND AVE STE 104E
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2452
Mailing Address - Country:US
Mailing Address - Phone:541-224-7712
Mailing Address - Fax:
Practice Address - Street 1:400 E 2ND AVE STE 104E
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2452
Practice Address - Country:US
Practice Address - Phone:541-224-7712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5111101YP2500X
ORT1692106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional