Provider Demographics
NPI:1033269162
Name:BEEMAN, MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BEEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 NORTH ELEVENTH AVENUE EAST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352
Mailing Address - Country:US
Mailing Address - Phone:320-808-4330
Mailing Address - Fax:
Practice Address - Street 1:214 4TH ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3330
Practice Address - Country:US
Practice Address - Phone:320-214-8558
Practice Address - Fax:320-235-2733
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN00398101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional