Active NPI
Kathleen Beaulieu, LPC, CRCC
- Professional Counselor
- Erie, PA
National Provider Identifier
1376966150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC001574
- Practice address
- 4380 W 12TH St
Suite 3
Erie, PA 16505-3028 - Phone
- (814) 392-9829
- NPI assigned
- Jan 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | CRCC00016415 | IL | |
| Professional Counselor | 101YP2500X | PC001574 | PA | Primary |
Addresses
Primary practice location
4380 W 12TH St
Suite 3
Erie, PA 16505-3028
Mailing address
4380 W 12TH St
Suite 3
Erie, PA 16505-3028
Phone (814) 392-9829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CRCC00016415 | IL | MD | Counselor |
| PC001574 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390953600000",
"number": "1376966150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4380 W 12TH ST",
"address_2": "SUITE 3",
"city": "ERIE",
"state": "PA",
"postal_code": "165053028",
"telephone_number": "814-392-9829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4380 W 12TH ST",
"address_2": "SUITE 3",
"city": "ERIE",
"state": "PA",
"postal_code": "165053028",
"telephone_number": "814-392-9829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAULIEU",
"first_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "LPC, CRCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-29",
"last_updated": "2014-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "CRCC00016415",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC001574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.