Provider Demographics
NPI:1497433908
Name:CALLENDER, BECKY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:ANN
Last Name:CALLENDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 N FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3312
Mailing Address - Country:US
Mailing Address - Phone:517-930-0455
Mailing Address - Fax:
Practice Address - Street 1:411 W LAKE LANSING RD STE B110
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8468
Practice Address - Country:US
Practice Address - Phone:517-657-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISC0000251101YS0200X
MI6401008964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool