Healthcare Provider Details

I. General information

NPI: 1235221789
Provider Name (Legal Business Name): LUCILLE B BECK PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 IRVING ST NW
WASHINGTON DC
20422-0001
US

IV. Provider business mailing address

6000 WESTERN AVE
CHEVY CHASE MD
20815-3346
US

V. Phone/Fax

Practice location:
  • Phone: 202-745-8578
  • Fax: 202-745-8579
Mailing address:
  • Phone: 202-745-8578
  • Fax: 202-745-8579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00763
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: