Active NPI
Lisa Davidson Becker, PH.D.
- School Psychologist
- Dekalb, IL
National Provider Identifier
1720766934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 1888300
- Practice address
- 901 S 4TH St
Dekalb, IL 60115-4411 - Phone
- (815) 754-1736
- NPI assigned
- Jul 7, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 1888300 | IL | Primary |
Addresses
Primary practice location
901 S 4TH St
Dekalb, IL 60115-4411
Mailing address
901 S 4TH St
Dekalb, IL 60115-4411
Phone (815) 754-1736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1888300 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688688000000",
"number": "1720766934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 S 4TH ST",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154411",
"telephone_number": "815-754-1736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 S 4TH ST",
"city": "DEKALB",
"state": "IL",
"postal_code": "601154411",
"telephone_number": "815-754-1736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "LISA",
"middle_name": "DAVIDSON",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-07",
"last_updated": "2023-07-07",
"certification_date": "2023-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "1888300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.