BEVERLY MIX (NPI# 1255583175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255583175 |
| Entity Type | Individual |
| Full Name | BEVERLY MIX |
| Credential | LPC |
| Practice Address |
1841 Madora Ave Douglas WY 82633-3057 |
| Practice Telephone | 3073582792 |
| Practice Fax Number | 3072585329 |
| Mailing Telephone | 3073582792 |
| Mailing Fax Number | 3072585329 |
| Enumeration Date | 2008-10-22 |
| Last Update Date | 2008-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LPC | WY | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LPC | WY | Behavioral Health & Social Service Providers |
| Street Address |
1841 MADORA AVE |
| City | DOUGLAS |
| State | WY |
| Zip Code | 82633-3057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225003023 | Solutions for Life | Clinic/Center | 1841 Madora Ave, Douglas, WY 82633-3057 | 2006-02-23 |
| 1821602475 | Kelly Ross | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2020-09-01 |
| 1447863626 | Jayme Donaldson | Nurse Practitioner | 1841 Madora Ave, Douglas, WY 82633-3057 | 2020-08-26 |
| 1669010633 | Kara A Mitchell | Case Manager/Care Coordinator | 1841 Madora Ave, Douglas, WY 82633-3057 | 2019-12-20 |
| 1669014833 | Roman Moss | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2019-10-09 |
| 1699324996 | Magaly Guerrero | Social Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2019-09-09 |
| 1700443140 | Rhylee Ramsey | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2019-05-21 |
| 1093283830 | Brooke Hannah Marcus | Case Manager/Care Coordinator | 1841 Madora Ave, Douglas, WY 82633-3057 | 2018-11-09 |
| 1902373962 | Jacqueline M Bowen | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2018-10-29 |
| 1508331216 | Wendy Hill | Community Health Worker | 1841 Madora Ave, Douglas, WY 82633-3057 | 2018-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710304399 | A Keeler Family Dental, LLC | Dentist | 1010 E Richards Street, Douglas, WY 82633 | 2014-03-21 |
| 1578836805 | Dawn Marie Marchak-cundy | Counselor | 1841 Madora Avenue, Douglas, WY 82633 | 2012-02-16 |
| 1982894739 | Tanisha Crystal Dexter | Pharmacist | 1202 East Richards Street, Douglas, WY 82633 | 2007-07-27 |
| 1669521324 | Stephan Paul Ediss | Chiropractor | 1330 E. Richards, Douglas, WY 82633 | 2007-01-10 |
| 1831280221 | Shauna R Kohler | Nurse Anesthetist, Certified Registered | 111 S 5th Street, Douglas, WY 82633 | 2006-09-28 |
| 1255438651 | County of Converse | Public Health or Welfare | 442 Center, Douglas, WY 82633 | 2006-09-20 |
| 1104834134 | Mark W Townsend | Dentist | 820 So 10th, Douglas, WY 82633 | 2006-08-04 |
| 1548206642 | Douglas Care Center, LLC | Skilled Nursing Facility | 1108 Birch, Douglas, WY 82633 | 2006-06-20 |
| 1023061223 | North Platte Physical Therapy Services Inc | Physical Therapist | Crook Co Memorial Serv Dist, Sundance, WY 82633 | 2006-05-18 |
| 1902447477 | Amanda Kay Dykes | Nurse Practitioner | 111 S 5th St, Douglas, WY 82633 | 2019-10-04 |
| Find all providers in zip 82633 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124395306 | Mary Doris Fitzgerald | Counselor | 2130 Lawson Creek Rd, Douglas, AK 99824-5010 | 2011-11-16 |
| 1013085943 | Paula K Russo | Counselor | 41 Oak St., Douglas, MA 01516-2215 | 2006-11-30 |
| 1619413580 | Patrick Charles Remington | Counselor | 121 Franklin St, Douglas, MA 01516-2334 | 2017-01-16 |
| 1750823555 | Zelenia Olivia Pellat | Counselor | 1701 N Douglas Ave, Douglas, AZ 85607-1019 | 2016-11-09 |
| 1457744864 | Jillian Alfeo | Counselor | 306 Main St, Douglas, MA 01516-2178 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965719 | Jerry Tyrone Smith | Counselor | 6818 Pasadena Rd, Cheyenne, WY 82009-2812 | 2020-06-02 |
| 1427684877 | Ashley V Evans | Counselor | 1629 Washakie Loop Unit A, Cheyenne, WY 82001-7186 | 2020-03-18 |
| 1912552001 | King & Samson Consulting Services LLC | Counselor | 831 E 7th St, Sheridan, WY 82801-3106 | 2019-08-06 |
| 1194382150 | Brain Advancement Center, LLC | Counselor | 2005 Warren Ave., Cheyenne, WY 82001 | 2019-05-24 |
| 1376100776 | Jason M Reasor | Counselor | 24 Country Club Ln., Pinedale, WY 82941 | 2019-05-22 |
| 1841762648 | Cynthia Jean Garhart | Counselor | 235 East 2nd Street, Powell, WY 82435 | 2018-12-19 |
| 1427528488 | Richard Percifield | Counselor | 400 N 1st East St Ste 107a, Green River, WY 82935-4247 | 2018-12-03 |
| 1548748593 | Susan F Markus | Counselor | 4318 Green Prairie Pl, Cheyenne, WY 82001-2303 | 2018-08-01 |
| 1649757196 | Jose Guillermo Rivas | Counselor | 140 E Broadway Ave # B-13, Jackson, WY 83001-8632 | 2018-07-26 |
| 1265931935 | Lyndsey Ellen Burton | Counselor | 400 S Kendrick Ave Ste 202, Gillette, WY 82716-3800 | 2018-02-07 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on BEVERLY MIX.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.