Provider Demographics
NPI:1710258728
Name:BECKER-FINN, GABRIEL STORM (MA, LPCC)
Entity Type:Individual
Prefix:
First Name:GABRIEL
Middle Name:STORM
Last Name:BECKER-FINN
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 IHDUHAPI RD
Mailing Address - Street 2:
Mailing Address - City:LORETTO
Mailing Address - State:MN
Mailing Address - Zip Code:55357-2120
Mailing Address - Country:US
Mailing Address - Phone:763-479-3555
Mailing Address - Fax:763-479-7130
Practice Address - Street 1:3675 IHDUHAPI RD
Practice Address - Street 2:
Practice Address - City:LORETTO
Practice Address - State:MN
Practice Address - Zip Code:55357-2120
Practice Address - Country:US
Practice Address - Phone:763-479-3555
Practice Address - Fax:763-479-7130
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00372101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional