Individual
DUSTIN BEATY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1047 VISTA PARK DR STE A, FOREST, VA 24551-4362
(434) 616-2388
Mailing address
1047 VISTA PARK DR STE A, FOREST, VA 24551-4362
(434) 616-2388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704013722
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704013722
RESIDENT IN COUNSELING LICENSE
VA
Enumeration date
03/04/2021
Last updated
03/04/2021
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