Provider Demographics
NPI:1144253600
Name:BECKWITH, ELAINE (NCC, LMHC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CORTES AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1302
Mailing Address - Country:US
Mailing Address - Phone:561-373-4431
Mailing Address - Fax:561-753-8752
Practice Address - Street 1:120 CORTES AVE
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1302
Practice Address - Country:US
Practice Address - Phone:561-373-4431
Practice Address - Fax:561-753-8752
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH00002970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health