Healthcare Provider Details

I. General information

NPI: 1215854666
Provider Name (Legal Business Name): MAXINE BECKVERMIT THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1112 TOWNSHIP PKWY
BELMONT NC
28012-9635
US

IV. Provider business mailing address

1112 TOWNSHIP PKWY
BELMONT NC
28012-9635
US

V. Phone/Fax

Practice location:
  • Phone: 980-288-4708
  • Fax:
Mailing address:
  • Phone: 845-702-5370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MAXINE VALENCIA BECKVERMIT
Title or Position: THERAPIST
Credential: LCSW
Phone: 980-288-4708