Provider Demographics
NPI:1487815312
Name:BEECHER, KELLEY RENEE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:RENEE
Last Name:BEECHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4615 SOUTHWEST FWY
Mailing Address - Street 2:STE 860
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7143
Mailing Address - Country:US
Mailing Address - Phone:713-623-2861
Mailing Address - Fax:713-623-0189
Practice Address - Street 1:4615 SOUTHWEST FWY
Practice Address - Street 2:STE 860
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7143
Practice Address - Country:US
Practice Address - Phone:713-623-2861
Practice Address - Fax:713-623-0189
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX360951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1951220-02Medicaid