Healthcare Provider Details

I. General information

NPI: 1568524163
Provider Name (Legal Business Name): SUSAN NEALE BECKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 WARTBURG PL APT 3M
MOUNT VERNON NY
10552-3865
US

IV. Provider business mailing address

3 WARTBURG PL APT 3M
MOUNT VERNON NY
10552-3865
US

V. Phone/Fax

Practice location:
  • Phone: 914-844-8304
  • Fax: 914-949-5169
Mailing address:
  • Phone: 914-844-8304
  • Fax: 914-949-5169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR027601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: