Provider Demographics
NPI:1588677702
Name:BEER, ARDALE L (MSW)
Entity Type:Individual
Prefix:
First Name:ARDALE
Middle Name:L
Last Name:BEER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 HIGH HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4203
Mailing Address - Country:US
Mailing Address - Phone:919-460-3371
Mailing Address - Fax:919-460-3359
Practice Address - Street 1:232 HIGH HOUSE RD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-4203
Practice Address - Country:US
Practice Address - Phone:919-460-3371
Practice Address - Fax:919-460-3359
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC004921104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003652Medicaid