Healthcare Provider Details

I. General information

NPI: 1639741002
Provider Name (Legal Business Name): JANE MARIE BECK MA, LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BRIARCREST DR
BRYAN TX
77802-2529
US

IV. Provider business mailing address

911 NAVIDAD ST
BRYAN TX
77801-2818
US

V. Phone/Fax

Practice location:
  • Phone: 979-229-7636
  • Fax:
Mailing address:
  • Phone: 832-458-9555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number97435
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: