Provider Demographics
NPI:1932071982
Name:BECK, ASHTYN BROOKE (LAC)
Entity type:Individual
Prefix:
First Name:ASHTYN
Middle Name:BROOKE
Last Name:BECK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DE WITT
Mailing Address - State:AR
Mailing Address - Zip Code:72042-2303
Mailing Address - Country:US
Mailing Address - Phone:870-509-1150
Mailing Address - Fax:
Practice Address - Street 1:1718 S GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-3449
Practice Address - Country:US
Practice Address - Phone:870-946-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2507025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional