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NPI Code Detail

MEDICARE: MR. KERRY J BECK LISW-SUPV

MEDICARE: MR. KERRY J BECK LISW-SUPV
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
1101YM0800XMental Health CounselorI.0700134-SUPVOH
21041C0700XClinical Social WorkerI.0700134-SUPVOH

General Provider Information

NPI Number : 1922271212
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KERRY J BECK LISW-SUPV
Provider Business Mailing Address
First Line : 329 N WEST ST
Second Line :
City : LIMA
State : OH
Zip : 45801-4331
Country : US
Telephone Number : 419-221-3072
Fax Number :
Provider Business Practice Location Address
First Line : 228 S MAIN ST
Second Line :
City : BRYAN
State : OH
Zip : 43506-1755
Country : US
Telephone Number : 567-239-4562
Fax Number : 419-225-8878
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2008
Last Update Date : 12/19/2024

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