Provider Demographics
NPI:1740519768
Name:BEILER, JANELLE MARIE
Entity type:Individual
Prefix:MRS
First Name:JANELLE
Middle Name:MARIE
Last Name:BEILER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-4905
Mailing Address - Country:US
Mailing Address - Phone:443-859-8584
Mailing Address - Fax:443-859-8496
Practice Address - Street 1:116 W MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-4905
Practice Address - Country:US
Practice Address - Phone:443-859-8584
Practice Address - Fax:443-859-8496
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD609550004Medicaid
MD609550001Medicaid
MD609550002Medicaid