Provider Demographics
NPI:1790701100
Name:BEERE, DONALD B (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:B
Last Name:BEERE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:767 WOODSIDE CT
Mailing Address - Street 2:
Mailing Address - City:VILLA HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1475
Mailing Address - Country:US
Mailing Address - Phone:859-426-9094
Mailing Address - Fax:
Practice Address - Street 1:7000 HOUSTON RD
Practice Address - Street 2:BUILDING 200 SUITE 15
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4873
Practice Address - Country:US
Practice Address - Phone:859-746-1006
Practice Address - Fax:859-746-1496
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1217103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical