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General NPI Number Information
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NPI Number | 1851930788
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Entity Type | Organization
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Legal Business Name | BEASLEY COUNSELING PLLC
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Dates
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Enumeration Date | 12/23/2019
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 311 RANCH ROAD 620 S, BUILDING 311, SUITE 102 LAKE TRAVIS BUSINESS PARK
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City | AUSTIN
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State | TX
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Zip | 78734
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Country | US
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Telephone | 512-699-9357
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Fax | 512-266-2226
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Provider Business Mailing Address
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Address Line | 311 RANCH ROAD 620 S, BUILDING 311, SUITE 102 LAKE TRAVIS BUSINESS PARK
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City | AUSTIN
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State | TX
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Zip | 78734
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Country | US
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Telephone | 512-699-9357
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Fax | 512-266-2226
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY BEASLEY
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Credential | LPC
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Telephone | 512-699-9357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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