Healthcare Provider Details

I. General information

NPI: 1326165424
Provider Name (Legal Business Name): WILLIAM JOHN BECKER LMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 SO. 17TH ST.
LINCOLN NE
68502
US

IV. Provider business mailing address

2201 SO. 17TH ST.
LINCOLN NE
68502
US

V. Phone/Fax

Practice location:
  • Phone: 402-441-7940
  • Fax:
Mailing address:
  • Phone: 402-441-7940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3438
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: