Provider Demographics
NPI:1649301268
Name:BEAL, CHAD A
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:A
Last Name:BEAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 NORD AVE APT 430
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-4648
Mailing Address - Country:US
Mailing Address - Phone:530-514-1392
Mailing Address - Fax:530-895-6548
Practice Address - Street 1:109 PARMAC RD STE 1
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2218
Practice Address - Country:US
Practice Address - Phone:530-891-2986
Practice Address - Fax:530-895-6549
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health