Provider Demographics
NPI:1538567722
Name:BEEMER, TERESA LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:LYNN
Last Name:BEEMER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:BEEMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:11417 SE MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97216-3501
Mailing Address - Country:US
Mailing Address - Phone:503-969-7301
Mailing Address - Fax:844-638-2504
Practice Address - Street 1:11417 SE MARKET ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97216-3501
Practice Address - Country:US
Practice Address - Phone:503-969-7301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-20
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1323101YM0800X
WALH8231101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health