Provider Demographics
NPI:1386791648
Name:BECKER, JEFFREY (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 FLOWERING TREE TER
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5802
Mailing Address - Country:US
Mailing Address - Phone:301-593-6632
Mailing Address - Fax:301-929-3305
Practice Address - Street 1:11501 GEORGIA AVE STE 407
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1955
Practice Address - Country:US
Practice Address - Phone:240-281-4669
Practice Address - Fax:240-314-1049
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD054581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical