# BEACON BEHAVIORAL HEALTH SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912243148
- **Authorized official:** KARLA BUSKIRK (OFFICE MANAGER)
- **Authorized official phone:** (701) 356-1276

## Contact information

- **Practice address:** 102 W BEATON DR, SUITE 103, WEST FARGO, ND 58078-2652
- **Practice address phone:** (701) 356-1276
- **Practice address fax:** (701) 356-4940
- **Mailing address:** 102 W BEATON DR, SUITE 103, WEST FARGO, ND 58078-2652
- **Mailing address phone:** (701) 356-1276
- **Mailing address fax:** (701) 356-4940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 372 | ND | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | 421 | ND | — |

## Other

- **Enumeration date:** 12/16/2012
- **Last updated:** 12/16/2012