Healthcare Provider Details

I. General information

NPI: 1043385495
Provider Name (Legal Business Name): BEVERLY ANN FRATES MCMAHON MS LMHP LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEVERLY ANN FRATES MS LMHP LADC

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 EAST A ST SUITE B
OGALLALA NE
69153
US

IV. Provider business mailing address

319 EAST A SUITE B
OGALLALA NE
69153
US

V. Phone/Fax

Practice location:
  • Phone: 308-284-6519
  • Fax: 308-284-6513
Mailing address:
  • Phone: 308-284-6519
  • Fax: 308-284-6513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number403
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number311
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number431
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: