Provider Demographics
NPI:1588829600
Name:BEATRICE, NORMA JEAN (LCDC)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:BEATRICE
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6500 BOING
Mailing Address - Street 2:STE L 150
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1156
Mailing Address - Country:US
Mailing Address - Phone:915-779-5600
Mailing Address - Fax:915-779-5605
Practice Address - Street 1:6500 BOING
Practice Address - Street 2:STE L 150
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1156
Practice Address - Country:US
Practice Address - Phone:915-779-5600
Practice Address - Fax:915-779-5605
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8546101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)