MEDICARE: MAXINE VALENCIA BECKVERMIT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C015862	NC

General Provider Information

NPI Number	:	1063020840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAXINE VALENCIA BECKVERMIT LCSW

Provider Business Mailing Address
First Line	:	1112 TOWNSHIP PKWY
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-9635
Country	:	US
Telephone Number	:	980-288-4708
Fax Number	:

Provider Business Practice Location Address
First Line	:	1112 TOWNSHIP PKWY
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-9635
Country	:	US
Telephone Number	:	980-288-4708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	06/19/2026

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