Provider Demographics
NPI:1588833479
Name:BEYER, WILLIAM EDWARD (LSPE-HSP, LPC-MHSP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:EDWARD
Last Name:BEYER
Suffix:
Gender:M
Credentials:LSPE-HSP, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SECURITY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3754
Mailing Address - Country:US
Mailing Address - Phone:731-660-2850
Mailing Address - Fax:731-660-2850
Practice Address - Street 1:25 SECURITY DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3754
Practice Address - Country:US
Practice Address - Phone:731-660-2850
Practice Address - Fax:731-660-2850
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000416101YP2500X
TNPE0000001755103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional