Provider Demographics
NPI:1235620949
Name:BECKMAN, KYRA J (LMFT)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:J
Last Name:BECKMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 UNIVERSITY AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-4925
Mailing Address - Country:US
Mailing Address - Phone:608-424-2413
Mailing Address - Fax:608-729-3434
Practice Address - Street 1:520 UNIVERSITY AVE STE 340
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4925
Practice Address - Country:US
Practice Address - Phone:608-424-2413
Practice Address - Fax:608-729-3434
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI541-228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist