Healthcare Provider Details

I. General information

NPI: 1669654240
Provider Name (Legal Business Name): LEIGH ARDEN BECK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 01/10/2025
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JUSTICE WORKS BEHAVIORAL CARE 4 CARRIAGE LANE, SUITE 405
CHARLESTON SC
29407
US

IV. Provider business mailing address

JUSTICE WORKS BEHAVIORAL CARE 4 CARRIAGE LANE, SUITE 405
CHARLESTON SC
29407
US

V. Phone/Fax

Practice location:
  • Phone: 843-974-5934
  • Fax: 843-647-7768
Mailing address:
  • Phone: 843-974-5934
  • Fax: 843-647-7768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2966
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: