Provider Demographics
NPI:1265644272
Name:ABOVE AND BEYOND COUNSELING & PSR, LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND COUNSELING & PSR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:DARREL
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:BS, PRS
Authorized Official - Phone:208-521-7225
Mailing Address - Street 1:545 SHOUP AVE
Mailing Address - Street 2:SUITE #321
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-3575
Mailing Address - Country:US
Mailing Address - Phone:208-521-7225
Mailing Address - Fax:208-524-9019
Practice Address - Street 1:545 SHOUP AVE
Practice Address - Street 2:SUITE #321
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-3575
Practice Address - Country:US
Practice Address - Phone:208-521-7225
Practice Address - Fax:208-524-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807357300Medicaid