MEDICARE: DR. CHERYL ANNE BEATRICE P.H.D, L.M.F.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	LFMT-15899	AZ
2	106H00000X	Marriage & Family Therapist	37FI00230600	NJ
3	106H00000X	Marriage & Family Therapist	LMFT99156	CA

General Provider Information

NPI Number	:	1093259426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL ANNE BEATRICE P.H.D, L.M.F.T.

Provider Business Mailing Address
First Line	:	6547 N ACADEMY BLVD # 1175
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-8342
Country	:	US
Telephone Number	:	805-208-1256
Fax Number	:

Provider Business Practice Location Address
First Line	:	6547 N ACADEMY BLVD # 1175
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-8342
Country	:	US
Telephone Number	:	805-208-1256
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2016
Last Update Date	:	11/12/2024

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