Pamela J Becker, LICSW

Individual provider Active NPI Clinical Social Worker · Oakdale, MN

NPI 1366523359 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1366523359
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
16620 (MN)
Practice address
7066 Stillwater Blvd N
Oakdale, MN 55128-3937
Phone
(651) 777-5222
Fax
(651) 251-5111
NPI assigned
Oct 18, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
16620MNMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16620 MN Yes

Addresses

Primary practice location

7066 Stillwater Blvd N
Oakdale, MN 55128-3937

Mailing address

7066 Stillwater Blvd N
Oakdale, MN 55128-3937
Phone (651) 777-5222

Other identifiers

IdentifierTypeStateIssuer
73416OtherMNHP
13N22BEOtherMNBCBS

Other providers in Oakdale, MN

All providers in Oakdale, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.