MEDICARE: SHERRY ANN BECK LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	3453	OK

General Provider Information

NPI Number	:	1386881365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY ANN BECK LPC

Provider Business Mailing Address
First Line	:	6212 SE 11TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-2454
Country	:	US
Telephone Number	:	405-570-4211
Fax Number	:

Provider Business Practice Location Address
First Line	:	6212 SE 11TH ST
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-2454
Country	:	US
Telephone Number	:	405-570-4211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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