Provider Demographics
NPI:1124371190
Name:BEAIRD, MARK ALLEN (LPC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ALLEN
Last Name:BEAIRD
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 FRANKLIN STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-270-7399
Mailing Address - Fax:256-517-8382
Practice Address - Street 1:333 FRANKLIN STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-270-7399
Practice Address - Fax:256-517-8382
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional