Provider Demographics
NPI:1982697587
Name:JOHNSON, BECKY LEE (MS LPC)
Entity Type:Individual
Prefix:MS
First Name:BECKY
Middle Name:LEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E 8TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-7011
Mailing Address - Country:US
Mailing Address - Phone:605-332-1700
Mailing Address - Fax:605-332-2894
Practice Address - Street 1:401 E 8TH ST
Practice Address - Street 2:SUITE 302
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-7011
Practice Address - Country:US
Practice Address - Phone:605-332-1700
Practice Address - Fax:605-332-2894
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC743101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional