Provider Demographics
NPI:1023384104
Name:BEAM, BRENAE C (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:BRENAE
Middle Name:C
Last Name:BEAM
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5006
Mailing Address - Country:US
Mailing Address - Phone:402-370-3140
Mailing Address - Fax:402-370-3373
Practice Address - Street 1:900 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5006
Practice Address - Country:US
Practice Address - Phone:402-370-3140
Practice Address - Fax:402-370-3373
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9387101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor