Provider Demographics
NPI:1962614651
Name:BECK, LAURA (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1390 BEEMER CT
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-4804
Mailing Address - Country:US
Mailing Address - Phone:248-628-2084
Mailing Address - Fax:
Practice Address - Street 1:50 WAYNE ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2159
Practice Address - Country:US
Practice Address - Phone:248-333-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical