Provider Demographics
NPI:1992092308
Name:BECKFORD, TOMASINA (LCSWR)
Entity type:Individual
Prefix:MS
First Name:TOMASINA
Middle Name:
Last Name:BECKFORD
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5839
Mailing Address - Country:US
Mailing Address - Phone:631-835-8630
Mailing Address - Fax:
Practice Address - Street 1:112 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5839
Practice Address - Country:US
Practice Address - Phone:631-835-8630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0402441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY390200000XMedicaid