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General NPI Number Information
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NPI Number | 1942402367
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Entity Type | Individual
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Provider Name | DONALD G. BEAL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 274 SOUTHLAND DR STE 204
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City | LEXINGTON
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State | KY
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Zip | 40503-1946
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Country | US
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Telephone | 859-278-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 1977 TWAIN RIDGE DR
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City | LEXINGTON
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State | KY
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Zip | 40514-1806
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Country | US
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Telephone | 859-223-8062
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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 | KY-0578
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | KY-0578
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | KY-0578
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License Number State | KY
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