MEDICARE: MS. KATHERINE BEEBE LCMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	068-0000286	VT

General Provider Information

NPI Number	:	1013217009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE BEEBE LCMHC

Provider Business Mailing Address
First Line	:	75 FAIRFIELD ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-2051
Country	:	US
Telephone Number	:	802-524-2002
Fax Number	:	802-527-1915

Provider Business Practice Location Address
First Line	:	75 FAIRFIELD ST
Second Line	:
City	:	SAINT ALBANS
State	:	VT
Zip	:	05478-2051
Country	:	US
Telephone Number	:	802-524-2002
Fax Number	:	802-527-1915

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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