Provider Demographics
NPI:1457195646
Name:BEYER, COLLEEN KATHERINE (LPCC)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:KATHERINE
Last Name:BEYER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13995 CLIFTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2637
Mailing Address - Country:US
Mailing Address - Phone:440-989-6685
Mailing Address - Fax:
Practice Address - Street 1:17306 MADISON AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3533
Practice Address - Country:US
Practice Address - Phone:440-989-6685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2202973101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor