Provider Demographics
NPI:1285448779
Name:BECKETT, SARKA (QMHP-R, CADC-R)
Entity type:Individual
Prefix:
First Name:SARKA
Middle Name:
Last Name:BECKETT
Suffix:
Gender:F
Credentials:QMHP-R, CADC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 NE SANDY BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2884
Mailing Address - Country:US
Mailing Address - Phone:971-990-1068
Mailing Address - Fax:
Practice Address - Street 1:1805 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2884
Practice Address - Country:US
Practice Address - Phone:971-990-1068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)