=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740427749
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIM ANN BEEKMAN-DEW LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2009
-----------------------------------------------------
Last Update Date | 09/04/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 699 BERKMAR COURT
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-260-0830
-----------------------------------------------------
Fax | 855-944-3374
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 699 BERKMAR COURT
-----------------------------------------------------
City | CHARLOTTESVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-936-3233
-----------------------------------------------------
Fax | 855-944-3374
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 2654
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC0701005826
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------