Healthcare Provider Details

I. General information

NPI: 1083552616
Provider Name (Legal Business Name): MR. DANNY JOSEPH BEASLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CURRENT DRIVE ROOM 205, CAMPUS BOX 7639
RALEIGH NC
27695-0001
US

IV. Provider business mailing address

10 CURRENT DRIVE ROOM 205, CAMPUS BOX 7639
RALEIGH NC
27695-0001
US

V. Phone/Fax

Practice location:
  • Phone: 919-515-2492
  • Fax:
Mailing address:
  • Phone: 919-515-2492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: