Provider Demographics
NPI:1659803492
Name:BEAUCHAMP, DARSI D (MA)
Entity Type:Individual
Prefix:
First Name:DARSI
Middle Name:D
Last Name:BEAUCHAMP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SPEEDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960
Mailing Address - Country:US
Mailing Address - Phone:973-400-9794
Mailing Address - Fax:973-695-1465
Practice Address - Street 1:152 SPEEDWELL AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-8816
Practice Address - Country:US
Practice Address - Phone:973-400-9794
Practice Address - Fax:973-695-1465
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00357400103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy