Provider Demographics
NPI:1033787197
Name:BEECH, SAMANTHA D
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:D
Last Name:BEECH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 CITY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-9514
Mailing Address - Country:US
Mailing Address - Phone:601-716-4712
Mailing Address - Fax:
Practice Address - Street 1:3205 NEW HIGHWAY 51
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-6513
Practice Address - Country:US
Practice Address - Phone:985-625-1809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health