Active NPI
Maria L Becker, HSPP
- Clinical Psychologist
- South Bend, IN
National Provider Identifier
1497721542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20041739A
- Practice address
- 310 N Ironwood Dr
South Bend, IN 46615-2520 - Phone
- (574) 287-6333
- Fax
- (574) 287-5651
- NPI assigned
- Feb 28, 2006
- Last updated
- Jul 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20041739A | IN | Primary |
Addresses
Primary practice location
310 N Ironwood Dr
South Bend, IN 46615-2520
Mailing address
1159 E Victoria St
South Bend, IN 46614-1445
Phone (574) 287-3137
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041739A | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184803200000",
"number": "1497721542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1159 E VICTORIA ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466141445",
"telephone_number": "574-287-3137",
"fax_number": "574-287-5651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 N IRONWOOD DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466152520",
"telephone_number": "574-287-6333",
"fax_number": "574-287-5651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "MARIA",
"middle_name": "L",
"credential": "HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-28",
"last_updated": "2007-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20041739A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.