MEDICARE: LISA NOELLE BECKER MA

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	102L00000X	Psychoanalyst

General Provider Information

NPI Number	:	1780494377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA NOELLE BECKER MA

Provider Business Mailing Address
First Line	:	215 COLLEGE AVE
Second Line	:
City	:	WEBSTER GROVES
State	:	MO
Zip	:	63119-1631
Country	:	US
Telephone Number	:	314-307-1597
Fax Number	:

Provider Business Practice Location Address
First Line	:	2362 COUNTRY RD
Second Line	:
City	:	SHILOH
State	:	IL
Zip	:	62221-2570
Country	:	US
Telephone Number	:	773-659-9207
Fax Number	:

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

Provider Enumeration Date	:	01/07/2025
Last Update Date	:	01/07/2025

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Directions to “ LISA NOELLE BECKER MA” Practice Location

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