Provider Demographics
NPI:1558076588
Name:BEECHAM, PEACHES (MSW)
Entity Type:Individual
Prefix:MRS
First Name:PEACHES
Middle Name:
Last Name:BEECHAM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:PEACHES
Other - Middle Name:
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 CHURCHMANS RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1945
Mailing Address - Country:US
Mailing Address - Phone:877-286-5115
Mailing Address - Fax:
Practice Address - Street 1:620 CHURCHMANS RD STE 103
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1945
Practice Address - Country:US
Practice Address - Phone:877-286-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker