MEDICARE: MRS. SHERYL BECKETT LICSW, LCSW

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	104100000X	Social Worker	R073992-01	NY
2	104100000X	Social Worker	LC500B1468	DC

General Provider Information

NPI Number	:	1750044673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERYL BECKETT LICSW, LCSW

Provider Business Mailing Address
First Line	:	4119 DAVIS PLACE NW APT 103
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007
Country	:	US
Telephone Number	:	914-439-2588
Fax Number	:

Provider Business Practice Location Address
First Line	:	4119 DAVIS PLACE NW APT 103
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007
Country	:	US
Telephone Number	:	914-439-2588
Fax Number	:

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

Provider Enumeration Date	:	10/18/2021
Last Update Date	:	10/18/2021

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