Provider Demographics
NPI:1497961171
Name:BEACH, NORMAN HENRY (LMHC)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:HENRY
Last Name:BEACH
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 GASTON ST.
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121
Mailing Address - Country:US
Mailing Address - Phone:617-869-9143
Mailing Address - Fax:
Practice Address - Street 1:38 GASTON ST.
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121
Practice Address - Country:US
Practice Address - Phone:617-869-9143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health