MEDICARE: MR. RANDY S BEEKMAN M.F.T.

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	106H00000X	Marriage & Family Therapist	0803	NV

General Provider Information

NPI Number	:	1922160324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RANDY S BEEKMAN M.F.T.

Provider Business Mailing Address
First Line	:	5820S PECOS RD 100
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-5432
Country	:	US
Telephone Number	:	702-339-0346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 E TROPICANA AVE
Second Line	:	SUITE 310
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-6517
Country	:	US
Telephone Number	:	702-650-0623
Fax Number	:	702-650-0624

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	11/15/2015

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