Provider Demographics
NPI:1821363474
Name:SCHULDT, BECKY R (MS, LPC-MH)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:R
Last Name:SCHULDT
Suffix:
Gender:F
Credentials:MS, LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 S ROOSEVELT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-6593
Mailing Address - Country:US
Mailing Address - Phone:605-846-7038
Mailing Address - Fax:605-401-4087
Practice Address - Street 1:634 S ROOSEVELT ST STE 4
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6593
Practice Address - Country:US
Practice Address - Phone:605-846-7038
Practice Address - Fax:605-401-4087
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH30527101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD3008056Medicaid