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NPI Code Detail

MEDICARE: MARTIN BECK CSW

MEDICARE:   MARTIN  BECK  CSW
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
11041C0700XClinical Social Worker258054KY

General Provider Information

NPI Number : 1457037608
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTIN BECK CSW
Provider Business Mailing Address
First Line : 4601 SHELBY LN
Second Line :
City : LEXINGTON
State : KY
Zip : 40515-8533
Country : US
Telephone Number : 646-831-2018
Fax Number :
Provider Business Practice Location Address
First Line : 535 W SECOND ST STE 207
Second Line :
City : LEXINGTON
State : KY
Zip : 40508-1268
Country : US
Telephone Number : 646-831-2018
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2023
Last Update Date : 06/23/2023

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Directions to “ MARTIN BECK CSW” Practice Location

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