Provider Demographics
NPI:1780479196
Name:BEALE, SIERRA L (ICF)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:L
Last Name:BEALE
Suffix:
Gender:
Credentials:ICF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:642 SAMS POINT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-2237
Mailing Address - Country:US
Mailing Address - Phone:843-941-3389
Mailing Address - Fax:
Practice Address - Street 1:642 SAMS POINT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-2237
Practice Address - Country:US
Practice Address - Phone:843-941-3389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach