Provider Demographics
NPI:1588403109
Name:SAM BECKMANN MENTAL HEALTH
Entity type:Organization
Organization Name:SAM BECKMANN MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BECKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:360-836-4254
Mailing Address - Street 1:15809 NE 32ND ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-7340
Mailing Address - Country:US
Mailing Address - Phone:254-881-9251
Mailing Address - Fax:
Practice Address - Street 1:15809 NE 32ND ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-7340
Practice Address - Country:US
Practice Address - Phone:254-881-9251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty