Individual provider Active NPI

Connie L Beckham, LCSW

  • Clinical Social Worker
  • Katy, TX
National Provider Identifier
1205165552
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
20032 Issued in TX
Practice address
21320 Provincial Blvd
Katy, TX 77450-7580
Phone
(281) 725-3838
NPI assigned
Dec 16, 2009
Last updated
Dec 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 20032 TX Primary

Addresses

Primary practice location

21320 Provincial Blvd
Katy, TX 77450-7580

Mailing address

26511 Park Point LN
Katy, TX 77494-8513
Phone (281) 693-2486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20032TXMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1205165552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26511 PARK POINT LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774948513",
            "telephone_number": "281-693-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21320 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-725-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "CONNIE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "20032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.