Healthcare Provider Details

I. General information

NPI: 1790189702
Provider Name (Legal Business Name): KATIE ELIZABETH BEDDINGFIELD LCSW, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE ELIZABETH LAMBRIGHT LCSW, LMFT

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 03/11/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 TOWNE CENTER BLVD. SUITE 103
RIDGELAND MS
39157
US

IV. Provider business mailing address

223 CHIPPEWA CIR
JACKSON MS
39211-6517
US

V. Phone/Fax

Practice location:
  • Phone: 601-624-7352
  • Fax:
Mailing address:
  • Phone: 601-624-7352
  • Fax: 769-233-7865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC8247
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: