Provider Demographics
NPI:1770940645
Name:BECK, KRISTEN BROOKE (MS, LPC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:BROOKE
Last Name:BECK
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:BROOKE
Other - Last Name:HELMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 865
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-0197
Mailing Address - Country:US
Mailing Address - Phone:503-766-9083
Mailing Address - Fax:
Practice Address - Street 1:4527 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-6115
Practice Address - Country:US
Practice Address - Phone:503-766-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-24
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC5661101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health