=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275614067
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAULA G BECKENSTEIN LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9 WHITLAW CLOSE
-----------------------------------------------------
City | CHAPPAQUE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10514-1011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-242-8647
-----------------------------------------------------
Fax | 914-241-3887
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 WHITLAW CLOSE
-----------------------------------------------------
City | CHAPPAQUE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10514-1011
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-242-8647
-----------------------------------------------------
Fax | 914-241-3887
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | PR0027491
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------