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General NPI Number Information
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NPI Number | 1598091985
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Entity Type | Individual
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Provider Name | BRADLEY SCOTT BEAM PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 8229 CLOVERLEAF DRIVE; SUITE 425 HALCYON WELLNESS CENTER
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2645
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Country | US
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Telephone | 443-875-5509
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 FALCON NEST COURT
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City | ARNOLD
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State | MD
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Zip | 21012
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Country | US
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Telephone | 443-875-5509
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | CER-152895-W5D7H2
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 04627
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License Number State | MD
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