MEDICARE: MR. LARRY FRANKLIN BEATTY MS CIT CISM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1598927162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LARRY FRANKLIN BEATTY MS CIT CISM

Provider Business Mailing Address
First Line	:	3260 COLLIN DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5015
Country	:	US
Telephone Number	:	561-649-5567
Fax Number	:

Provider Business Practice Location Address
First Line	:	3260 COLLIN DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33406-5015
Country	:	US
Telephone Number	:	561-649-5567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	10/12/2010

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