Provider Demographics
NPI:1619305075
Name:BECK-FRATE, KIMBERLY BARR (EDD, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:BARR
Last Name:BECK-FRATE
Suffix:
Gender:F
Credentials:EDD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 SEABREEZE BLVD.
Mailing Address - Street 2:INTEGRATIVE CRISIS MANAGEMENT, SUITE 725
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118
Mailing Address - Country:US
Mailing Address - Phone:386-255-0044
Mailing Address - Fax:386-255-0045
Practice Address - Street 1:444 SEABREEZE BLVD.
Practice Address - Street 2:INTEGRATIVE CRISIS MANAGEMENT, SUITE 725
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118
Practice Address - Country:US
Practice Address - Phone:386-255-0044
Practice Address - Fax:386-255-0045
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6317101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health