Provider Demographics
NPI:1679838767
Name:BEALL COUNSELING LLC
Entity Type:Organization
Organization Name:BEALL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:R
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LPC
Authorized Official - Phone:918-916-9001
Mailing Address - Street 1:PO BOX 33
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-0033
Mailing Address - Country:US
Mailing Address - Phone:918-916-9001
Mailing Address - Fax:
Practice Address - Street 1:1116 BRANDYWINE LN UNIT 5
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-2091
Practice Address - Country:US
Practice Address - Phone:918-916-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3518101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty