Provider Demographics
NPI:1568697662
Name:BECK, LEIGH WASSEL (DSW, LCSWC, LICSW)
Entity type:Individual
Prefix:DR
First Name:LEIGH
Middle Name:WASSEL
Last Name:BECK
Suffix:
Gender:F
Credentials:DSW, LCSWC, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4917 TARTAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9666
Mailing Address - Country:US
Mailing Address - Phone:617-899-4664
Mailing Address - Fax:
Practice Address - Street 1:4917 TARTAN HILL RD
Practice Address - Street 2:
Practice Address - City:PERRY HALL
Practice Address - State:MD
Practice Address - Zip Code:21128-9666
Practice Address - Country:US
Practice Address - Phone:617-899-4664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32007104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker