MEDICARE: TYLER BEAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	RBT-19-82086	NC
2	103K00000X	Behavior Analyst	1-22-60550	NC

General Provider Information

NPI Number	:	1124694583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER BEAL

Provider Business Mailing Address
First Line	:	350 FAIRWAY DR STE 101
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-1834
Country	:	US
Telephone Number	:	910-374-5991
Fax Number	:

Provider Business Practice Location Address
First Line	:	2585 OLD GLORY RD UNIT 109
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-9276
Country	:	US
Telephone Number	:	336-568-8386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2021
Last Update Date	:	03/10/2026

Similar Medicare Providers

1568303055 — VERSIFE GHAM GODLOVE
Practice Location Address:

2585 OLD GLORY RD UNIT 109
CLEMMONS, NC
27012-9276

Practice Phone: 336-510-7910
Practice Fax: 336-510-9974

1700727062 — ASHLYNN WAGNER
Practice Location Address:

2585 OLD GLORY RD UNIT 109
CLEMMONS, NC
27012-9276

Practice Phone: 336-510-7910
Practice Fax: 336-510-9974

1003761396 — DONNA C TRAINER
Practice Location Address:

2585 OLD GLORY RD STE 109
CLEMMONS, NC
27012-9276

Practice Phone: 336-510-7910
Practice Fax:

1548594948 — SALEM MOBILITY AND MEDICAL SUPPLY INC
Practice Location Address:

2565A OLD GLORY RD
CLEMMONS, NC
27012-9276

Practice Phone: 336-766-4480
Practice Fax: 336-766-4498

1871452201 — SARAH BETH WHITE
Practice Location Address:

2585 OLD GLORY RD
CLEMMONS, NC
27012-9276

Practice Phone: 252-665-0316
Practice Fax:

1306786413 — JOANNE CLARKIN GONZALEZ SLP
Practice Location Address:

8155 WHITMORE COVE LN
CLEMMONS, NC
27012-8881

Practice Phone: 336-995-2046
Practice Fax:

Directions to “ TYLER BEAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.