Provider Demographics
NPI:1922565563
Name:BEAL, JAYME RAE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JAYME
Middle Name:RAE
Last Name:BEAL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTNUT ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1477
Mailing Address - Country:US
Mailing Address - Phone:325-437-1001
Mailing Address - Fax:325-437-1005
Practice Address - Street 1:500 CHESTNUT ST STE 1001
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1477
Practice Address - Country:US
Practice Address - Phone:325-437-1001
Practice Address - Fax:325-437-1005
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-01
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional