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General NPI Number Information
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NPI Number | 1245481563
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Entity Type | Individual
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Provider Name | PEARL BEASON LPC
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Gender | Female
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 5111 ROGERS AVE SUITE 521
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City | FORT SMITH
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State | AR
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Zip | 72903-2047
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Country | US
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Telephone | 479-657-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 23824 STEWART LOOP
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City | SPIRO
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State | OK
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Zip | 74959-4756
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Country | US
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Telephone | 918-385-1067
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P0801011
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License Number State | AR
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