Provider Demographics
NPI:1689646291
Name:BURGMEYER, BETH G (MSED)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:G
Last Name:BURGMEYER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4460 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:IA
Mailing Address - Zip Code:50211-1812
Mailing Address - Country:US
Mailing Address - Phone:515-473-1028
Mailing Address - Fax:
Practice Address - Street 1:10896 NIXON ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-7226
Practice Address - Country:US
Practice Address - Phone:515-473-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00423101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health