MEDICARE: MR. MARC JOSEPH BECKER LISW

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	I 0005649	OH

General Provider Information

NPI Number	:	1902933237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARC JOSEPH BECKER LISW

Provider Business Mailing Address
First Line	:	555 W SCHROCK RD
Second Line	:	MED WEST II STE. 220
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8702
Country	:	US
Telephone Number	:	614-895-9998
Fax Number	:	614-895-9592

Provider Business Practice Location Address
First Line	:	555 W SCHROCK RD
Second Line	:	MED WEST II STE. 220
City	:	WESTERVILLE
State	:	OH
Zip	:	43081-8702
Country	:	US
Telephone Number	:	614-895-9998
Fax Number	:	614-895-9592

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	01/07/2014

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