Provider Demographics
NPI:1588549448
Name:BECKER, JULIA DIANA (LMSW)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:DIANA
Last Name:BECKER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 KETAY DR S
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-5032
Mailing Address - Country:US
Mailing Address - Phone:631-487-9050
Mailing Address - Fax:
Practice Address - Street 1:285 E MAIN ST STE LL5
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2980
Practice Address - Country:US
Practice Address - Phone:631-724-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128002104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker