Provider Demographics
NPI:1629175781
Name:BEAL, ANN BARTLETT (LPC)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:BARTLETT
Last Name:BEAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 FM 156 SOUTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052
Mailing Address - Country:US
Mailing Address - Phone:817-501-1638
Mailing Address - Fax:817-439-0273
Practice Address - Street 1:1395 FM 156 SOUTH
Practice Address - Street 2:SUITE 105
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052
Practice Address - Country:US
Practice Address - Phone:817-501-1638
Practice Address - Fax:817-439-0273
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1131526Medicaid
TX6623LCOtherBLUE CROSS BLUE SHIELD