Healthcare Provider Details

I. General information

NPI: 1609030295
Provider Name (Legal Business Name): BECKER PSYCHOLOGICAL SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 05/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 PERSHING DR SUITE 004
SILVER SPRING MD
20910
US

IV. Provider business mailing address

804 PERSHING DR STE 4
SILVER SPRING MD
20910-4436
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-3088
  • Fax:
Mailing address:
  • Phone: 301-385-8830
  • Fax: 301-588-3087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number04379
License Number StateMD

VIII. Authorized Official

Name: MS. BARBARA E CARTER
Title or Position: BILLING/OFFICE MANAGER
Credential:
Phone: 142-725-8062