Healthcare Provider Details
I. General information
NPI: 1710280029
Provider Name (Legal Business Name): BETH LEIGH HAUSER LCMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/08/2010
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13500 NC HIGHWAY 50 STE 225
SURF CITY NC
28445-7934
US
IV. Provider business mailing address
604 ALSTON BLVD
HAMPSTEAD NC
28443-8124
US
V. Phone/Fax
- Phone: 910-689-4601
- Fax:
- Phone: 910-689-4601
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 4409 |
| License Number State | TN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 97943 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 9132 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: