National Provider Identifier

Theresa Marie Beach, LCSW R

Theresa Marie Beach, LCSW R is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Canandaigua, NY and a listed phone number of (585) 394-1294.

NPI 1073562542Canandaigua, NYMental Health Counselor

Profile Overview

NPI
1073562542
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
May 10, 2006
Last Updated
July 13, 2010

Practice Location

  • 527 N Main St
  • Canandaigua, NY 14424-1021

Phone: (585) 394-1294

Specialties

  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1073562542
Entity Type
Individual
Last Name
Beach
First Name
Theresa
Middle Name
Marie
Name Prefix
Mrs.
Credential
LCSW R
Mailing Street Address
527 N Main St
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-1021
Mailing Country
US
Mailing Phone
(585) 394-1294
Mailing Fax
(585) 394-1294
Practice Street Address
527 N Main St
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1021
Practice Country
US
Practice Phone
(585) 394-1294
Practice Fax
(585) 394-1294
Enumeration Date
May 10, 2006
Last Updated
July 13, 2010
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X)
Other Identifiers
338407 (NY, Mvp Value Options), P010044998 (NY, Blue Cross Blue Shield)