Provider Demographics
NPI:1528197050
Name:BEYNON, CHRIS T (LICSW)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:T
Last Name:BEYNON
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BELCHERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01007-9545
Mailing Address - Country:US
Mailing Address - Phone:413-323-0502
Mailing Address - Fax:
Practice Address - Street 1:136 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BELCHERTOWN
Practice Address - State:MA
Practice Address - Zip Code:01007-9545
Practice Address - Country:US
Practice Address - Phone:413-323-0502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical