Provider Demographics
NPI:1043735129
Name:MCBEATH, PATRICE N (LPC)
Entity Type:Individual
Prefix:
First Name:PATRICE
Middle Name:N
Last Name:MCBEATH
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 1:4545 S 23RD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2720
Mailing Address - Country:US
Mailing Address - Phone:414-573-1084
Mailing Address - Fax:
Practice Address - Street 1:2200 N 12TH ST STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-1320
Practice Address - Country:US
Practice Address - Phone:414-367-8518
Practice Address - Fax:414-677-7219
Is Sole Proprietor?:No
Enumeration Date:2017-08-09
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WI7261-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100072314Medicaid