Provider Demographics
NPI:1417297235
Name:BEAVERS, ANDREW HUNTER (JD, MSE, MSA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:HUNTER
Last Name:BEAVERS
Suffix:
Gender:M
Credentials:JD, MSE, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 WALTON RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-9600
Mailing Address - Country:US
Mailing Address - Phone:501-834-7333
Mailing Address - Fax:
Practice Address - Street 1:37 WALTON RD.
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120
Practice Address - Country:US
Practice Address - Phone:501-834-7333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0291L101YA0400X
GAAPC002732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health