Provider Demographics
NPI:1962970608
Name:BECK, MICHAEL (LCSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BECK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:MIKE
Other - Middle Name:
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:50 BRIDGE ST APT 207
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-1176
Mailing Address - Country:US
Mailing Address - Phone:718-650-1665
Mailing Address - Fax:
Practice Address - Street 1:1 CHRISTOPHER ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10014-3582
Practice Address - Country:US
Practice Address - Phone:929-265-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1045661041C0700X
NY0929651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical