Provider Demographics
NPI:1578047072
Name:BEARD, RITA (MBA, MAMFT, CSAYC)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:BEARD
Suffix:
Gender:F
Credentials:MBA, MAMFT, CSAYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6100 N KEYSTONE AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2892
Mailing Address - Country:US
Mailing Address - Phone:317-296-4914
Mailing Address - Fax:317-713-0177
Practice Address - Street 1:5760 LIEBER RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46228-1909
Practice Address - Country:US
Practice Address - Phone:317-908-9665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty