Provider Demographics
NPI:1679109375
Name:BECKER, KENT (EDD, LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:
Last Name:BECKER
Suffix:
Gender:M
Credentials:EDD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3309 CUCHARA CT
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-5576
Mailing Address - Country:US
Mailing Address - Phone:307-760-9059
Mailing Address - Fax:
Practice Address - Street 1:3309 CUCHARA CT
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-5576
Practice Address - Country:US
Practice Address - Phone:307-760-9059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-14
Last Update Date:2020-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-647101Y00000X
COMFT.0001666106H00000X
WYLMFT-088106H00000X
COLPC.0001171101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist