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General NPI Number Information
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NPI Number | 1811104243
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Entity Type | Individual
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Provider Name | JOHN A. BEACH M.ED.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 923 ROUTE 6A BUILDING 7, 2ND FLOOR
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City | YARMOUTH PORT
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State | MA
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Zip | 02675-2159
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Country | US
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Telephone | 508-362-7692
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Fax |
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Provider Business Mailing Address
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Address Line | 923 ROUTE 6A P.O. BOX 524
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City | YARMOUTH PORT
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State | MA
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Zip | 02675-2159
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Country | US
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Telephone | 508-362-7692
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 495
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 495
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License Number State | MA
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