Healthcare Provider Details

I. General information

NPI: 1811209422
Provider Name (Legal Business Name): JUDITH KAY BECK LPC, LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 08/24/2026
Certification Date:
Deactivation Date: 12/11/2025
Reactivation Date: 08/24/2026

III. Provider practice location address

905 BRITTANY
WAGONER OK
74467-8192
US

IV. Provider business mailing address

905 BRITTANY
WAGONER OK
74467-8192
US

V. Phone/Fax

Practice location:
  • Phone: 918-351-4583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number682
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1867
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: