MEDICARE: WENDY BECKER PSYCHOTHERAPY

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	261QM0850X	Adult Mental Health Clinic/Center
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1629686498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WENDY BECKER PSYCHOTHERAPY

Provider Business Mailing Address
First Line	:	515 EDWARDSVILLE RD UNIT 90
Second Line	:
City	:	TROY
State	:	IL
Zip	:	62294-7003
Country	:	US
Telephone Number	:	253-432-8389
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 EDWARDSVILLE RD UNIT 90
Second Line	:
City	:	TROY
State	:	IL
Zip	:	62294-7003
Country	:	US
Telephone Number	:	253-432-8389
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WENDY BECKER
Credential	:
Telephone Number	:	253-432-8389

Provider Enumeration Date	:	07/17/2020
Last Update Date	:	12/16/2025

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