Joseph Beeney Ph D Psychologist Inc | |
650 N Main St Fort Bragg CA 95437-3220 | |
(707) 421-8884 | |
Not Available |
Full Name | Joseph Beeney Ph D Psychologist Inc |
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Speciality | Clinic/Center |
Location | 650 N Main St, Fort Bragg, California |
Authorized Official Name and Position | Joseph Edward Beeney (PRESIDENT) |
Authorized Official Contact | 7079725089 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Joseph Beeney Ph D Psychologist Inc 720 N Harrison St Fort Bragg CA 95437-3125 Ph: (707) 421-8884 | Joseph Beeney Ph D Psychologist Inc 650 N Main St Fort Bragg CA 95437-3220 Ph: (707) 421-8884 |
NPI Number | 1073228698 |
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Provider Enumeration Date | 01/18/2023 |
Last Update Date | 05/15/2023 |
Certification Date | 05/15/2023 |
Medicare PECOS PAC ID | 8022475789 |
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Medicare Enrollment ID | O20230612001369 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073228698 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
Provider Name | Joseph Edward Beeney |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1588004709 PECOS PAC ID: 7416371638 Enrollment ID: I20230531003303 |
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