Healthcare Provider Details

I. General information

NPI: 1225700677
Provider Name (Legal Business Name): BRIDGET NICOLE BEYER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NEW KARNER RD
ALBANY NY
12205-3854
US

IV. Provider business mailing address

970 WASHINGTON AVE APT 3
ALBANY NY
12203-1952
US

V. Phone/Fax

Practice location:
  • Phone: 518-431-1650
  • Fax: 518-447-0429
Mailing address:
  • Phone: 985-640-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number122412
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: