Provider Demographics
NPI:1538345020
Name:BECK, KIMBERLY S (LSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:S
Last Name:BECK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:S
Other - Last Name:UMSTEADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6626 E 75TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1030 E COUNTY LINE RD STE C1
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-2998
Practice Address - Country:US
Practice Address - Phone:317-497-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
IN34006233A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker