Healthcare Provider Details

I. General information

NPI: 1558572883
Provider Name (Legal Business Name): MARSHA E BECKETT LCPC, LCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31491 EDEN ALLEN RD
EDEN MD
21822-2278
US

IV. Provider business mailing address

110 W CHURCH ST STE D
SALISBURY MD
21801-5001
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-1282
  • Fax: 410-543-1901
Mailing address:
  • Phone: 443-840-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0485
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: