Provider Demographics
NPI:1992949374
Name:BECKER, CASEY WHEELER (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:CASEY
Middle Name:WHEELER
Last Name:BECKER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 NESTLING CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-2637
Mailing Address - Country:US
Mailing Address - Phone:617-797-7949
Mailing Address - Fax:
Practice Address - Street 1:1121 NESTLING CT
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-2637
Practice Address - Country:US
Practice Address - Phone:617-797-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7730101YM0800X
FL12488101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health