Provider Demographics
NPI:1386482024
Name:BECKNER, CRAIG KLINE (LCMHCA)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:KLINE
Last Name:BECKNER
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 WOODLEIGH RD UNIT 105
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-1357
Mailing Address - Country:US
Mailing Address - Phone:336-266-6357
Mailing Address - Fax:
Practice Address - Street 1:3653 SWEETEN CREEK RD STE B
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-2769
Practice Address - Country:US
Practice Address - Phone:828-651-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20257101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health