Healthcare Provider Details

I. General information

NPI: 1467068148
Provider Name (Legal Business Name): AMY BEAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2020
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 E MAIN ST
LANCASTER OH
43130-3439
US

IV. Provider business mailing address

707 MINGO TER
LOGAN OH
43138-1215
US

V. Phone/Fax

Practice location:
  • Phone: 740-974-5780
  • Fax:
Mailing address:
  • Phone: 740-974-5780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number3701493
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number3701493
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: