Provider Demographics
NPI:1770029605
Name:BEITMAN, JAMES A (ADDICTION COUNSELOR)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:BEITMAN
Suffix:
Gender:M
Credentials:ADDICTION COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 EXECUTIVE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2611
Mailing Address - Country:US
Mailing Address - Phone:317-844-5742
Mailing Address - Fax:317-844-5737
Practice Address - Street 1:90 EXECUTIVE DR
Practice Address - Street 2:SUITE A
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2611
Practice Address - Country:US
Practice Address - Phone:317-844-5742
Practice Address - Fax:317-844-5737
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000613A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)