Individual
BETH A BERHORST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, LPC
Contact information
Practice address
201 N GARTH AVE, COLUMBIA, MO 65203-4105
(573) 449-3953
(573) 874-3189
Mailing address
3804 SHAMROCK RD, JEFFERSON CITY, MO 65101-9363
(573) 690-7996
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2003027650
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649269622
BILLING NPI
MO
01
—
506201904
HCY MEDICAID NUMBER
MO
05
—
862990702
—
MO
05
—
866201908
—
MO
Enumeration date
05/03/2007
Last updated
12/18/2020
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