Provider Demographics
NPI:1124207980
Name:BEATTY, JANE (LMHC, AAT)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:LMHC, AAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CARL LANDI CIR
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-7752
Mailing Address - Country:US
Mailing Address - Phone:508-274-8957
Mailing Address - Fax:508-437-0239
Practice Address - Street 1:133 FALMOUTH RD
Practice Address - Street 2:BUILDING 1, SUITE F
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-2611
Practice Address - Country:US
Practice Address - Phone:508-274-8957
Practice Address - Fax:508-477-2499
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical