Healthcare Provider Details

I. General information

NPI: 1114854510
Provider Name (Legal Business Name): MORGAN BECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 LONE TREE RD
ELM GROVE WI
53122-2018
US

IV. Provider business mailing address

1025 LONE TREE RD
ELM GROVE WI
53122-2018
US

V. Phone/Fax

Practice location:
  • Phone: 608-770-7104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10286125
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17139132
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: