Healthcare Provider Details

I. General information

NPI: 1356890271
Provider Name (Legal Business Name): STEVEN BEATY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 MACKEY BRANCH DR
CHATTANOOGA TN
37421-3225
US

IV. Provider business mailing address

1360 MACKEY BRANCH DR
CHATTANOOGA TN
37421-3225
US

V. Phone/Fax

Practice location:
  • Phone: 423-443-3336
  • Fax: 423-464-7510
Mailing address:
  • Phone: 423-443-3336
  • Fax: 423-464-7510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: