Provider Demographics
NPI:1689263089
Name:BEATO, BROOKE DAWN (LPC)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:DAWN
Last Name:BEATO
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 1:10921 PELLICANO DR STE 122
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4604
Mailing Address - Country:US
Mailing Address - Phone:915-200-4002
Mailing Address - Fax:
Practice Address - Street 1:10921 PELLICANO DR STE 122
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4604
Practice Address - Country:US
Practice Address - Phone:915-200-4002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77129101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health