Provider Demographics
NPI:1790189702
Name:BEDDINGFIELD, KATIE ELIZABETH (LCSW, LMFT)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:ELIZABETH
Last Name:BEDDINGFIELD
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:ELIZABETH
Other - Last Name:LAMBRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LMFT
Mailing Address - Street 1:223 CHIPPEWA CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-6517
Mailing Address - Country:US
Mailing Address - Phone:601-624-7352
Mailing Address - Fax:769-233-7865
Practice Address - Street 1:357 TOWNE CENTER BLVD.
Practice Address - Street 2:SUITE 103
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157
Practice Address - Country:US
Practice Address - Phone:601-624-7352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC82471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC8247OtherMS BOARD OF SOCIAL WORKERS