Provider Demographics
NPI:1043257181
Name:BECK, JENNIFER JONES (MSW, LCSW, DCSW, SAP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:JONES
Last Name:BECK
Suffix:
Gender:F
Credentials:MSW, LCSW, DCSW, SAP
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, DCSW, SAP
Mailing Address - Street 1:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:TX
Mailing Address - Zip Code:78362-1267
Mailing Address - Country:US
Mailing Address - Phone:361-523-8241
Mailing Address - Fax:
Practice Address - Street 1:521 WOODHAVEN
Practice Address - Street 2:
Practice Address - City:INGLESIDE
Practice Address - State:TX
Practice Address - Zip Code:78362-4678
Practice Address - Country:US
Practice Address - Phone:361-523-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS095731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87463QOtherBLUE CROSS BLUE SHIELD
TX87795QOtherBLUE CROSS BLUE SHIELD TX
TX170997402Medicaid
TX1709974 03Medicaid
TX8F5760Medicare PIN
TX8D5221Medicare ID - Type Unspecified