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Individual

DR. BEVERLY JEAN PATITZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LIMHP, LADC CPC

Contact information

Practice address
223 EAST 14TH,, SUITE 220, HASTINGS, NE 68901
(402) 519-0159
Mailing address
223 EAST 14TH,, SUITE 220, HASTINGS, NE 68901
(402) 519-0159

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
688
101YM0800X
Mental Health Counselor
Primary
945
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025039900
NE
01
588458000
MAGELLAN MIS NUMBER
NE
Enumeration date
12/08/2006
Last updated
02/08/2012
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