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General NPI Number Information
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NPI Number | 1912007584
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Entity Type | Individual
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Provider Name | ANDREW M BECKERMAN MSW
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 160 BENMONT AVE
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City | BENNINGTON
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State | VT
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Zip | 05201-1873
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Country | US
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Telephone | 802-379-6105
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Fax |
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Provider Business Mailing Address
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Address Line | 12 ROYAL ST
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City | NORTH BENNINGTON
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State | VT
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Zip | 05257-9580
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Country | US
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Telephone | 802-379-6105
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Fax | 802-851-5553
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 000089-13
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License Number State | VT
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