| Beacon Mental Health Resources Llc | |
|
1421 Broadway St N Ste 114b Menomonie WI 54751-4728 | |
| (715) 308-5742 | |
| (888) 972-4831 |
| Full Name | Beacon Mental Health Resources Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 1421 Broadway St N Ste 114b, Menomonie, Wisconsin |
| Authorized Official Name and Position | Rebecca Hustad (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7153085742 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Mental Health Resources Llc 1421 Broadway St N Ste 114b Menomonie WI 54751-4728 Ph: (715) 308-5742 | Beacon Mental Health Resources Llc 1421 Broadway St N Ste 114b Menomonie WI 54751-4728 Ph: (715) 308-5742 |
| NPI Number | 1407379787 |
|---|---|
| Provider Enumeration Date | 07/19/2017 |
| Last Update Date | 07/21/2022 |
| Certification Date | 08/04/2020 |
| Medicare PECOS PAC ID | 2668997586 |
|---|---|
| Medicare Enrollment ID | O20250423000990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407379787 | NPI | - | NPPES |
| 1518241876 | Other | MN | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1065 (Wisconsin) | Primary |
| Provider Name | Rebecca Hustad |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1518241876 PECOS PAC ID: 5395260210 Enrollment ID: I20250423001093 |
| Provider Name | Shae Marie Havner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710549183 PECOS PAC ID: 6901322593 Enrollment ID: I20250428000758 |
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