MEDICARE: ANN BARTLETT BEAL LPC

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	101YP2500X	Professional Counselor	15606	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	6623LC	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1629175781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANN BARTLETT BEAL LPC

Provider Business Mailing Address
First Line	:	1395 FM 156 SOUTH
Second Line	:	SUITE 105
City	:	HASLET
State	:	TX
Zip	:	76052
Country	:	US
Telephone Number	:	817-501-1638
Fax Number	:	817-439-0273

Provider Business Practice Location Address
First Line	:	1395 FM 156 SOUTH
Second Line	:	SUITE 105
City	:	HASLET
State	:	TX
Zip	:	76052
Country	:	US
Telephone Number	:	817-501-1638
Fax Number	:	817-439-0273

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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Directions to “ ANN BARTLETT BEAL LPC” Practice Location

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