Healthcare Provider Details

I. General information

NPI: 1275956906
Provider Name (Legal Business Name): KATHY WILLIAMS BEAUSEJOUR LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9133 CANOPY OAK LN APT 102
RIVERVIEW FL
33578-4714
US

IV. Provider business mailing address

520 N FALKENBURG RD
TAMPA FL
33619-7884
US

V. Phone/Fax

Practice location:
  • Phone: 727-281-6458
  • Fax:
Mailing address:
  • Phone: 727-281-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23316
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: