Provider Demographics
NPI:1164257127
Name:PHILIPSEN, BETH (LMCHCA)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:PHILIPSEN
Suffix:
Gender:F
Credentials:LMCHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5202 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-2616
Mailing Address - Country:US
Mailing Address - Phone:336-549-1976
Mailing Address - Fax:
Practice Address - Street 1:5202 W MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2616
Practice Address - Country:US
Practice Address - Phone:336-549-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-07
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health