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Individual

CHAD BEAVERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
901 WALLACE BLVD, AMARILLO, TX 79106-1705
(806) 364-6111
Mailing address
901 WALLACE BLVD, AMARILLO, TX 79106-1705
(806) 364-6111

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
15841
TX
101YP2500X
Professional Counselor
Primary
15841
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
028935701
TX
Enumeration date
06/06/2006
Last updated
11/28/2023
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