MEDICARE: MICHELLE N BEASLEY

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	101YM0800X	Mental Health Counselor	LAC-08340T	AZ

General Provider Information

NPI Number	:	1528927985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE N BEASLEY

Provider Business Mailing Address
First Line	:	4116 N 1ST AVE UNIT 1D
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1098
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6280 E PIMA ST STE 110
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-3074
Country	:	US
Telephone Number	:	602-726-2658
Fax Number	:

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

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “ MICHELLE N BEASLEY ” Practice Location

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