Provider Demographics
NPI:1831168723
Name:PRESTWOOD, BECKY JO (LCSW)
Entity type:Individual
Prefix:MS
First Name:BECKY
Middle Name:JO
Last Name:PRESTWOOD
Suffix:
Gender:F
Credentials:LCSW
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:MCHE-QD (CREDENTIALS)
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-2460
Mailing Address - Fax:210-916-5102
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE-QD (CREDENTIALS)
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-2460
Practice Address - Fax:210-916-5102
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX315141041C0700X
TX984281041C0700X
NMI-060081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical