Provider Demographics
NPI:1518238310
Name:LORRIE G. BEEVERS, PHD, PC
Entity Type:Organization
Organization Name:LORRIE G. BEEVERS, PHD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORRIE
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:BEEVERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:865-212-5296
Mailing Address - Street 1:679B EMORY VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-7756
Mailing Address - Country:US
Mailing Address - Phone:865-212-5296
Mailing Address - Fax:865-220-0782
Practice Address - Street 1:679B EMORY VALLEY RD
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-7756
Practice Address - Country:US
Practice Address - Phone:865-212-5296
Practice Address - Fax:865-220-0782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP832103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3688319Medicare UPIN