Provider Demographics
NPI:1760823439
Name:BEASLEY, ANDREW MCDONALD (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MCDONALD
Last Name:BEASLEY
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4785 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0513
Mailing Address - Country:US
Mailing Address - Phone:559-448-4914
Mailing Address - Fax:
Practice Address - Street 1:4785 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0500
Practice Address - Country:US
Practice Address - Phone:559-448-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IMF75107106H00000X
CA106529106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist