Healthcare Provider Details

I. General information

NPI: 1518139476
Provider Name (Legal Business Name): MARCIA L BECK LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1518 TANGLEWOOD AVE
NORTH MYRTLE BEACH SC
29582-2868
US

IV. Provider business mailing address

1518 TANGLEWOOD AVE
NORTH MYRTLE BEACH SC
29582-2868
US

V. Phone/Fax

Practice location:
  • Phone: 484-949-9659
  • Fax: 843-273-4159
Mailing address:
  • Phone: 484-949-9659
  • Fax: 843-273-4159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8892
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC016095
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015877
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: