Individual
JEREMEY BEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1707 LINWOOD DR STE G, PARAGOULD, AR 72450-5365
(870) 604-4455
(888) 977-2956
Mailing address
1707 LINWOOD DR STE G, PARAGOULD, AR 72450-5365
(870) 604-4455
(888) 977-2956
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
P1707328
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116399726
—
AR
Enumeration date
10/16/2008
Last updated
07/25/2022
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