Healthcare Provider Details

I. General information

NPI: 1437580669
Provider Name (Legal Business Name): PAMELA BECKERING LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 1ST ST N STE 101
SAINT CLOUD MN
56303-1924
US

IV. Provider business mailing address

7401 METRO BLVD STE 250
EDINA MN
55439-3062
US

V. Phone/Fax

Practice location:
  • Phone: 612-268-5858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number687
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number687
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: