Healthcare Provider Details

I. General information

NPI: 1134054570
Provider Name (Legal Business Name): KASHAN BECKFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 LYNNHURST BLVD
CHESAPEAKE VA
23321-4444
US

IV. Provider business mailing address

766 13TH AVE S
ST PETERSBURG FL
33701-5310
US

V. Phone/Fax

Practice location:
  • Phone: 757-315-3438
  • Fax:
Mailing address:
  • Phone: 757-315-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0903004966
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: