Healthcare Provider Details

I. General information

NPI: 1437909892
Provider Name (Legal Business Name): MARGARET BECKER THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LEONARD ST NE
GRAND RAPIDS MI
49505-5515
US

IV. Provider business mailing address

1400 LEONARD ST NE
GRAND RAPIDS MI
49505-5515
US

V. Phone/Fax

Practice location:
  • Phone: 616-965-1266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARGARET BECKER
Title or Position: OWNER
Credential:
Phone: 616-965-1266