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NPI Code Detail

MEDICARE: ASHLEY MAE BECKER LAC, CM

MEDICARE: ASHLEY MAE BECKER LAC, CM
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
1101YA0400XAddiction (Substance Use Disorder) Counselor2045ND

General Provider Information

NPI Number : 1639038607
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY MAE BECKER LAC, CM
Provider Business Mailing Address
First Line : 2624 9TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-2350
Country : US
Telephone Number : 701-498-4500
Fax Number : 701-298-4400
Provider Business Practice Location Address
First Line : 2624 9TH AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-2350
Country : US
Telephone Number : 701-298-4500
Fax Number : 701-298-4400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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