=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962291278
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLYSSA BECKMAN LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/02/2025
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7749 DEPEW ST
-----------------------------------------------------
City | ARVADA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80003-5820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-212-6204
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7749 DEPEW ST
-----------------------------------------------------
City | ARVADA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80003-5820
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-212-6204
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | STAFF CLINICIAN
-----------------------------------------------------
Name | ALLYSSA MARIE BECKMAN
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 949-212-6204
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------