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General NPI Number Information
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NPI Number | 1144693243
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Entity Type | Individual
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Provider Name | MELISSA BECKMAN MFT
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Gender | Female
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 145 VISTA LN
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City | TYRONE
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State | GA
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Zip | 30290-2619
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Country | US
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Telephone | 216-280-0175
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Fax |
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Provider Business Mailing Address
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Address Line | 145 VISTA LN
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City | TYRONE
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State | GA
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Zip | 30290-2619
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Country | US
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Telephone | 216-280-0175
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F.2100209
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 18-471
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 81114
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License Number State | CA
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