Beathea, Carol Joann

Beathea, Carol Joann is an individual health care provider with primary practice located at 330 W Lexington Ave Suite 206, Elkhart IN 46516. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Social Worker is her primary health care specialty. Beathea, Carol Joann can be contacted via phone (574) 293-5991.

Contact Information

Primary practice address
330 W Lexington Ave Suite 206 Elkhart IN 46516
Phone: (574) 293-5991
Fax: (574) 293-5429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 34000509A Indiana
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 34000509A Indiana

Profile Details

NPI number 1760565055
LBN Legal business name Beathea, Carol Joann
Credentials PHD LCSW MSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 23rd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760565055 NPPES
Other 000000183551 BCBS ANTHEM

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