Provider Demographics
NPI:1457404600
Name:BEAMAN, JOHN ROY (LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROY
Last Name:BEAMAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2412
Mailing Address - Country:US
Mailing Address - Phone:845-486-2950
Mailing Address - Fax:845-486-2999
Practice Address - Street 1:20 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2412
Practice Address - Country:US
Practice Address - Phone:845-486-2950
Practice Address - Fax:845-486-2999
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063224104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker