Provider Demographics
NPI:1902411093
Name:BECOMING BEHAVIORAL HEALTH & WELLNESS PLLC
Entity Type:Organization
Organization Name:BECOMING BEHAVIORAL HEALTH & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:EASON
Authorized Official - Suffix:
Authorized Official - Credentials:APN, PMHNP-BC
Authorized Official - Phone:708-441-9240
Mailing Address - Street 1:7900 INTERNATIONAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2562
Mailing Address - Country:US
Mailing Address - Phone:708-441-9240
Mailing Address - Fax:866-351-1969
Practice Address - Street 1:7900 INTERNATIONAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2562
Practice Address - Country:US
Practice Address - Phone:708-441-9240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL277000548OtherAPRN LICENSE
MN7401OtherAPRN LICENSE
NYF4025561OtherAPRN LICENSE