Provider Demographics
NPI:1083297808
Name:BEERMAN, KRISTY R (LMSW)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:R
Last Name:BEERMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 E TACOMA ST
Mailing Address - Street 2:
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-1520
Mailing Address - Country:US
Mailing Address - Phone:520-508-3141
Mailing Address - Fax:
Practice Address - Street 1:214 E TACOMA ST
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-1520
Practice Address - Country:US
Practice Address - Phone:520-508-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker