Basic Information
| Provider Information | |||||||||
| NPI: | 1831389113 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BEAM | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | B.S., QMHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1104 S MAYS ST STE 218 | ||||||||
| Address2: | |||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786646769 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417471235 | ||||||||
| FaxNumber: | 5477474722 | ||||||||
| Practice Location | |||||||||
| Address1: | 37875 JASPER LOWELL RD | ||||||||
| Address2: | |||||||||
| City: | JASPER | ||||||||
| State: | OR | ||||||||
| PostalCode: | 974389751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417471235 | ||||||||
| FaxNumber: | 5477474722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2007 | ||||||||
| LastUpdateDate: | 01/29/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YP1600X | Y | Behavioral Health & Social Service Providers | Counselor | Pastoral |
No ID Information.