Provider Demographics
NPI:1093259426
Name:BEATRICE, CHERYL ANNE (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANNE
Last Name:BEATRICE
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6547 N ACADEMY BLVD # 1175
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8342
Mailing Address - Country:US
Mailing Address - Phone:805-208-1256
Mailing Address - Fax:
Practice Address - Street 1:6547 N ACADEMY BLVD # 1175
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-8342
Practice Address - Country:US
Practice Address - Phone:805-208-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLFMT-15899106H00000X
NJ37FI00230600106H00000X
CALMFT99156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist