Provider Demographics
NPI:1073636965
Name:BEALE, CHARLES L (EDD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:BEALE
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:508 RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIVERSITY
Mailing Address - State:PA
Mailing Address - Zip Code:19352-9012
Mailing Address - Country:US
Mailing Address - Phone:610-869-4436
Mailing Address - Fax:610-869-4428
Practice Address - Street 1:62 N CHAPEL ST
Practice Address - Street 2:SUITE 203
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-2238
Practice Address - Country:US
Practice Address - Phone:302-369-9999
Practice Address - Fax:610-869-4428
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE122103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling