Provider Demographics
NPI:1538044953
Name:BECKSTEAD, SHELBY DAWN (LMSW)
Entity type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:DAWN
Last Name:BECKSTEAD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4443 E ARCADIA AVE
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-1422
Mailing Address - Country:US
Mailing Address - Phone:208-716-3996
Mailing Address - Fax:
Practice Address - Street 1:211 S WOODRUFF AVE STE A3
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-4865
Practice Address - Country:US
Practice Address - Phone:208-524-4818
Practice Address - Fax:208-522-6630
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1071275104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker