Provider Demographics
NPI:1235846460
Name:HEIN-BEARDSLEY, KIMBERLY (LMFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HEIN-BEARDSLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:HEIN (MAIDEN), WINKELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2650 NOVATION PKWY
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-3399
Mailing Address - Country:US
Mailing Address - Phone:608-471-4972
Mailing Address - Fax:
Practice Address - Street 1:2650 NOVATION PKWY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-3399
Practice Address - Country:US
Practice Address - Phone:608-471-4972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI633-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI409009700Medicaid