MEDICARE: BECKY ANN CALLENDER LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	SC0000251	MI
2	101YP2500X	Professional Counselor	6401008964	MI

General Provider Information

NPI Number	:	1497433908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECKY ANN CALLENDER LPC

Provider Business Mailing Address
First Line	:	1409 N FOSTER AVE
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3312
Country	:	US
Telephone Number	:	517-930-0455
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 W LAKE LANSING RD STE B110
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8468
Country	:	US
Telephone Number	:	517-657-3533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2023
Last Update Date	:	07/06/2023

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Directions to “ BECKY ANN CALLENDER LPC” Practice Location

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