Provider Demographics
NPI:1760805030
Name:BEEBLE, MATTHEW (MA, LMHC)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:
Last Name:BEEBLE
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E EVERGREEN BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3331
Mailing Address - Country:US
Mailing Address - Phone:360-606-3242
Mailing Address - Fax:888-959-7741
Practice Address - Street 1:400 E EVERGREEN BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3331
Practice Address - Country:US
Practice Address - Phone:360-606-3242
Practice Address - Fax:888-959-7741
Is Sole Proprietor?:No
Enumeration Date:2014-01-22
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60324815101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health