Provider Demographics
NPI:1417238874
Name:BEYRER, ANDREW J (LCSW, BCBA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:BEYRER
Suffix:
Gender:M
Credentials:LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 WHITAKER ST
Mailing Address - Street 2:APT A
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-5559
Mailing Address - Country:US
Mailing Address - Phone:859-466-7316
Mailing Address - Fax:
Practice Address - Street 1:639 JOHN CARTER RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:GA
Practice Address - Zip Code:31302-8065
Practice Address - Country:US
Practice Address - Phone:859-466-7316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0049441041C0700X
GA1-13-14291103K00000X
KY37371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst