Active NPI
Terry Becker
- Student in an Organized Health Care Education/Training Program
- Mattituck, NY
National Provider Identifier
1982467643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 7555 Main Rd
Mattituck, NY 11952-1516 - Phone
- (631) 298-8642
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 125404 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
7555 Main Rd
Mattituck, NY 11952-1516
Mailing address
4550 Stillwater Ave
Cutchogue, NY 11935-2402
Other practice location 1
3635 Bell Blvd Ste 203
Bayside, NY 11361-2097
Phone (718) 504-9256 ext. 49256
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125404 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758758400000",
"number": "1982467643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 STILLWATER AVE",
"city": "CUTCHOGUE",
"state": "NY",
"postal_code": "119352402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7555 MAIN RD",
"city": "MATTITUCK",
"state": "NY",
"postal_code": "119521516",
"telephone_number": "631-298-8642"
}
],
"practiceLocations": [
{
"address_1": "3635 Bell Blvd Ste 203",
"address_purpose": "LOCATION",
"city": "Bayside",
"state": "NY",
"postal_code": "113612097",
"country_code": "US",
"telephone_number": "718-504-9256 x49256",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECKER",
"first_name": "TERRY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "125404",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mattituck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.