| Beasley Family Therapy Services, Llc | |
|
124 Pearl St Ste 304 Ypsilanti MI 48197-2663 | |
| (734) 719-0448 | |
| Not Available |
| Full Name | Beasley Family Therapy Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 124 Pearl St Ste 304, Ypsilanti, Michigan |
| Authorized Official Name and Position | Anthany J Beasley (OWNER) |
| Authorized Official Contact | 7347190448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beasley Family Therapy Services, Llc 1175 Jay Ave Ypsilanti MI 48198-6462 Ph: (734) 719-0448 | Beasley Family Therapy Services, Llc 124 Pearl St Ste 304 Ypsilanti MI 48197-2663 Ph: (734) 719-0448 |
| NPI Number | 1326524208 |
|---|---|
| Provider Enumeration Date | 07/13/2018 |
| Last Update Date | 07/13/2018 |
| Medicare PECOS PAC ID | 6507118528 |
|---|---|
| Medicare Enrollment ID | O20181002002906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326524208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Anthany J Beasley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770971129 PECOS PAC ID: 8224380241 Enrollment ID: I20181012001873 |
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