Provider Demographics
NPI:1992495915
Name:BECK, SHIA (LMHC)
Entity type:Individual
Prefix:
First Name:SHIA
Middle Name:
Last Name:BECK
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 DECATUR AVE UNIT 212
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-7744
Mailing Address - Country:US
Mailing Address - Phone:646-406-5173
Mailing Address - Fax:
Practice Address - Street 1:12 MAPLE LEAF RD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3030
Practice Address - Country:US
Practice Address - Phone:845-459-5899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health