Provider Demographics
NPI:1548949316
Name:BECK, KARLEY (LMSW)
Entity type:Individual
Prefix:
First Name:KARLEY
Middle Name:
Last Name:BECK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 WEBER RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-3317
Mailing Address - Country:US
Mailing Address - Phone:573-644-1326
Mailing Address - Fax:
Practice Address - Street 1:400 N WASHINGTON ST STE 122
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-1702
Practice Address - Country:US
Practice Address - Phone:573-644-1326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR13115-M104100000X
MO2022017707104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker