Provider Demographics
NPI:1972651032
Name:BEAN, ATHENA H (LPC)
Entity Type:Individual
Prefix:MS
First Name:ATHENA
Middle Name:H
Last Name:BEAN
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 1:2700 HIGHWAY 377 S
Mailing Address - Street 2:SUITE 118
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-3902
Mailing Address - Country:US
Mailing Address - Phone:325-646-7594
Mailing Address - Fax:
Practice Address - Street 1:2700 HIGHWAY 377 S
Practice Address - Street 2:SUITE 118
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-3902
Practice Address - Country:US
Practice Address - Phone:325-646-7594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10696101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional