Healthcare Provider Details

I. General information

NPI: 1518017755
Provider Name (Legal Business Name): MICHAEL BECKLER MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MCAFEE U. S. ARMY HEALTH CLINIC
WHITE SANDS MISSILE RANGE NM
88011
US

IV. Provider business mailing address

5005 N. PIEDRAS STREET WILLIAM BEAUMONT ARMY MEDICAL CENTER
EL PASO TX
79920-5001
US

V. Phone/Fax

Practice location:
  • Phone: 505-678-4992
  • Fax:
Mailing address:
  • Phone: 915-569-1386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI-0019
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: