Provider Demographics
NPI:1710948369
Name:BECKSTEAD, MARGENE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARGENE
Middle Name:
Last Name:BECKSTEAD
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 1:3686 W 8620 S
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5528
Mailing Address - Country:US
Mailing Address - Phone:801-280-1863
Mailing Address - Fax:
Practice Address - Street 1:3703 W 6200 S
Practice Address - Street 2:
Practice Address - City:KEARNS
Practice Address - State:UT
Practice Address - Zip Code:84118-3749
Practice Address - Country:US
Practice Address - Phone:801-955-9686
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2697136004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional