Provider Demographics
NPI:1932961109
Name:RASMUSSEN, BECKY MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:MARIE
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:MARIE
Other - Last Name:SOKUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:707 SABLE OAKS DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6954
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 SABLE OAKS DR STE 230
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-6954
Practice Address - Country:US
Practice Address - Phone:207-387-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC7390101YP2500X
WALH61508699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health