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General NPI Number Information
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NPI Number | 1821782798
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Entity Type | Individual
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Provider Name | BRIDGET AILEEN BEACH LMFT-IT
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Gender | Female
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 111 W JACKSON ST
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54495-2702
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Country | US
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Telephone | 715-421-8845
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Fax | 715-421-2266
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Provider Business Mailing Address
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Address Line | 2413 COUNTY ROAD Y
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City | STEVENS POINT
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State | WI
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Zip | 54482-9323
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Country | US
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Telephone | 715-421-8845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1035-228
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License Number State | WI
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