Provider Demographics
NPI:1124694062
Name:BECKER, MERCEDES (LPCC)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 W 52ND AVE # A145
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-3725
Mailing Address - Country:US
Mailing Address - Phone:720-295-8203
Mailing Address - Fax:
Practice Address - Street 1:3400 TABLE MESA DR STE 102
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-5850
Practice Address - Country:US
Practice Address - Phone:720-295-8203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018466101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health