Provider Demographics
NPI:1194854042
Name:BEACHAM, ALICE EARL (LMSW LPC LMFT)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:EARL
Last Name:BEACHAM
Suffix:
Gender:F
Credentials:LMSW LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 CREEKSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071
Mailing Address - Country:US
Mailing Address - Phone:214-726-6496
Mailing Address - Fax:
Practice Address - Street 1:321 N CENTRAL EXPRWY
Practice Address - Street 2:#309
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071
Practice Address - Country:US
Practice Address - Phone:214-726-6496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14030101YP2500X
TX13584104100000X
TX4801106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker