Provider Demographics
NPI:1598927162
Name:BEATTY, LARRY FRANKLIN (MS CIT CISM)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:FRANKLIN
Last Name:BEATTY
Suffix:
Gender:M
Credentials:MS CIT CISM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3260 COLLIN DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5015
Mailing Address - Country:US
Mailing Address - Phone:561-649-5567
Mailing Address - Fax:
Practice Address - Street 1:3260 COLLIN DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5015
Practice Address - Country:US
Practice Address - Phone:561-649-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-25
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health