Healthcare Provider Details

I. General information

NPI: 1063803096
Provider Name (Legal Business Name): HALLIE BEECRAFT LPC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 7TH ST
RACINE WI
53403-1222
US

IV. Provider business mailing address

1320 WISCONSIN AVE
RACINE WI
53403-1978
US

V. Phone/Fax

Practice location:
  • Phone: 262-634-2391
  • Fax: 262-634-5342
Mailing address:
  • Phone: 262-687-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16125-132
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2692-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: