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NPI Code Detail

MEDICARE: LEO BEYDA LPC

MEDICARE: LEO BEYDA 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
1101YP2500XProfessional Counselor37PC00844900NJ

General Provider Information

NPI Number : 1669026910
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO BEYDA LPC
Provider Business Mailing Address
First Line : 14 STATION ST
Second Line :
City : MANALAPAN
State : NJ
Zip : 07726-4005
Country : US
Telephone Number : 732-682-7866
Fax Number :
Provider Business Practice Location Address
First Line : 901 ERNSTON RD
Second Line :
City : SOUTH AMBOY
State : NJ
Zip : 08879-2000
Country : US
Telephone Number : 732-654-3131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2019
Last Update Date : 05/08/2023

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Directions to “ LEO BEYDA LPC” Practice Location

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