Provider Demographics
NPI:1639260961
Name:BEATY, SHEILA BELL
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:BELL
Last Name:BEATY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1872 COUNTY ROAD 700
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-8734
Mailing Address - Country:US
Mailing Address - Phone:662-286-6555
Mailing Address - Fax:662-287-0283
Practice Address - Street 1:1872 COUNTY ROAD 700
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-8734
Practice Address - Country:US
Practice Address - Phone:662-286-6555
Practice Address - Fax:662-287-0283
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSTP 72822Medicaid
MS1626OtherLPC LICENSE NUMBER