Provider Demographics
NPI:1912925314
Name:BEACH, ALAN (PHD, LCSW, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:BEACH
Suffix:
Gender:M
Credentials:PHD, LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-5165
Mailing Address - Country:US
Mailing Address - Phone:540-387-3977
Mailing Address - Fax:540-387-3988
Practice Address - Street 1:811 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5165
Practice Address - Country:US
Practice Address - Phone:540-387-3977
Practice Address - Fax:540-387-3988
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040018141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical