Healthcare Provider Details

I. General information

NPI: 1215642541
Provider Name (Legal Business Name): VERONICA LYNN BECERRA RIVERA LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 4188
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 4188
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 443-390-9525
  • Fax:
Mailing address:
  • Phone: 443-390-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC15799
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: