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General NPI Number Information
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NPI Number | 1447750047
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Entity Type | Individual
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Provider Name | LIISA ANN BECKMAN MPS, LPCC LADC
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Gender | Female
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Dates
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Enumeration Date | 02/20/2018
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Last Update Date | 09/10/2020
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Provider Practice Location Address
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Address Line | 1821 UNIVERSITY AVE W STE N385
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City | SAINT PAUL
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State | MN
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Zip | 55104-2872
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Country | US
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Telephone | 612-454-2484
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Fax | 651-647-9147
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Provider Business Mailing Address
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Address Line | 550 MAIN STREET SUITE 250
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City | NEW BRIGHTON
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State | MN
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Zip | 55112-3271
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Country | US
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Telephone | 612-326-7575
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Fax | 612-454-2430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 304846
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2331
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 304846
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License Number State | MN
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