Provider Demographics
NPI:1750413357
Name:BEEBE, MICHAEL B (MED)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:B
Last Name:BEEBE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 CURTIS BROOK ROAD
Mailing Address - Street 2:
Mailing Address - City:LYNDEBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03082-6420
Mailing Address - Country:US
Mailing Address - Phone:603-654-9103
Mailing Address - Fax:
Practice Address - Street 1:17 OLD NASHUA ROAD
Practice Address - Street 2:#4
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2839
Practice Address - Country:US
Practice Address - Phone:603-622-3422
Practice Address - Fax:603-673-1492
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH065101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)