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General NPI Number Information
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NPI Number | 1942418967
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Entity Type | Individual
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Provider Name | SCOTT HARRISON BECKER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 2127 UNIVERSITY PARK DR
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City | OKEMOS
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State | MI
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Zip | 48864-5928
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Country | US
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Telephone | 800-693-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 4142 LEEWARD DR
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City | OKEMOS
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State | MI
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Zip | 48864-4400
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Country | US
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Telephone | 585-350-9655
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017100
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301014519
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License Number State | MI
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