Provider Demographics
NPI:1346332475
Name:BEATRICE, JAMES (PH,D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:BEATRICE
Suffix:
Gender:M
Credentials:PH,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 ARDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EARLYSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22936-9208
Mailing Address - Country:US
Mailing Address - Phone:434-975-5992
Mailing Address - Fax:434-979-8170
Practice Address - Street 1:530 ARDWOOD RD
Practice Address - Street 2:
Practice Address - City:EARLYSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22936-9208
Practice Address - Country:US
Practice Address - Phone:434-975-5992
Practice Address - Fax:434-979-8170
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical