Healthcare Provider Details

I. General information

NPI: 1821902115
Provider Name (Legal Business Name): BECK LIATT LCSW PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 RIDGEWOOD AVENUE PO BOX 83
GLEN RIDGE NJ
07028
US

IV. Provider business mailing address

225 RIDGEWOOD AVENUE PO BOX 83
GLEN RIDGE NJ
07028
US

V. Phone/Fax

Practice location:
  • Phone: 203-913-0420
  • Fax:
Mailing address:
  • Phone: 203-913-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BECK LIATT
Title or Position: OWNER
Credential:
Phone: 203-913-0420