MEDICARE: KATRINA BEARDMORE LPC

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	101YP2500X	Professional Counselor	7706	WI

General Provider Information

NPI Number	:	1396598058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA BEARDMORE LPC

Provider Business Mailing Address
First Line	:	830 N 109TH ST STE 1
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3754
Country	:	US
Telephone Number	:	608-535-9453
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 N 109TH ST STE 1
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-3754
Country	:	US
Telephone Number	:	608-535-9453
Fax Number	:

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

Provider Enumeration Date	:	04/10/2024
Last Update Date	:	12/08/2025

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Directions to “ KATRINA BEARDMORE LPC” Practice Location

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