MEDICARE: ANDREA BECKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LAC-23781	AZ
2	101YM0800X	Mental Health Counselor	1517-12-15-25A	ND

General Provider Information

NPI Number	:	1043176845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA BECKER

Provider Business Mailing Address
First Line	:	600 S 2ND ST STE 201
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58504-5729
Country	:	US
Telephone Number	:	701-258-3780
Fax Number	:	701-751-1328

Provider Business Practice Location Address
First Line	:	600 S 2ND ST STE 201
Second Line	:
City	:	BISMARCK
State	:	ND
Zip	:	58504-5729
Country	:	US
Telephone Number	:	701-258-3780
Fax Number	:	701-751-1328

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/25/2025
Last Update Date	:	12/25/2025

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Directions to “ ANDREA BECKER ” Practice Location

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