MEDICARE: DINAH ALETHEA BECKFORD

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1134936784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINAH ALETHEA BECKFORD

Provider Business Mailing Address
First Line	:	630 MOUNTAIN QUAIL DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28216-8103
Country	:	US
Telephone Number	:	973-718-0092
Fax Number	:

Provider Business Practice Location Address
First Line	:	6416 CARMEL RD STE 400B
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-8268
Country	:	US
Telephone Number	:	973-718-0092
Fax Number	:

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

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	12/17/2024

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