Provider Demographics
NPI:1073999082
Name:BEEM, LAURA NICOLE
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:NICOLE
Last Name:BEEM
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 1:1340 W MORSE AVE
Mailing Address - Street 2:503
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-3596
Mailing Address - Country:US
Mailing Address - Phone:312-351-1556
Mailing Address - Fax:
Practice Address - Street 1:1340 W MORSE AVE
Practice Address - Street 2:503
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-3596
Practice Address - Country:US
Practice Address - Phone:312-351-1556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst