Provider Demographics
NPI:1073900924
Name:BEATON, EUVADA SHERNAYE (MA, LAC)
Entity Type:Individual
Prefix:
First Name:EUVADA
Middle Name:SHERNAYE
Last Name:BEATON
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 S ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3036
Mailing Address - Country:US
Mailing Address - Phone:480-755-5553
Mailing Address - Fax:
Practice Address - Street 1:1921 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3036
Practice Address - Country:US
Practice Address - Phone:480-755-5553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC 15152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional