Healthcare Provider Details

I. General information

NPI: 1891425641
Provider Name (Legal Business Name): LUCIEN V BECKFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 W ROGERS AVE STE 1
BALTIMORE MD
21215-4749
US

IV. Provider business mailing address

3249 KINGSBRIDGE AVE
BRONX NY
10463-5514
US

V. Phone/Fax

Practice location:
  • Phone: 410-578-4340
  • Fax:
Mailing address:
  • Phone: 646-204-2295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP15107
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: