Beverly Mix, LPC
Individual provider Active NPI Mental Health Counselor · Douglas, WY
NPI 1255583175 · NPPES record last updated Oct 22, 2008
Key facts
- NPI
- 1255583175
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC (WY)
- Practice address
- 1841 Madora Ave
Douglas, WY 82633-3057 - Phone
- (307) 358-2792
- Fax
- (307) 258-5329
- NPI assigned
- Oct 22, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC | WY | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LPC | WY | |
| Mental Health Counselor | 101YM0800X | LPC | WY | Yes |
Addresses
Primary practice location
1841 Madora Ave
Douglas, WY 82633-3057
Mailing address
1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-2792
Other providers in Douglas, WY
- Memorial Hospital of Converse County
- Memorial Hospital of Converse County
- Memorial Hospital of Converse County
- Memorial Hospital of Converse County
- Mindful Connection Counseling
- Bobbyjo Moberly
- Chelsea Hana Moore
- James Forrest Morgan
- Thomas Morris
- Cheyenne Morrison
All providers in Douglas, WY · Mental Health Counselor in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.