Provider Demographics
NPI:1700552536
Name:BEACHY, MATTHEW (LPCC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:BEACHY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:MOUNT EATON
Mailing Address - State:OH
Mailing Address - Zip Code:44659-0265
Mailing Address - Country:US
Mailing Address - Phone:330-359-6100
Mailing Address - Fax:330-597-9010
Practice Address - Street 1:15550 DURSTINE RD
Practice Address - Street 2:
Practice Address - City:DUNDEE
Practice Address - State:OH
Practice Address - Zip Code:44624-9428
Practice Address - Country:US
Practice Address - Phone:330-359-6100
Practice Address - Fax:330-597-9010
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2102442101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional