Individual
MRS. DENITRA BEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6638
LA
101YP2500X
Professional Counselor
Primary
6638
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497111728
PRIVATE INSURANCE
LA
05
—
1497111728
—
LA
Enumeration date
12/31/2015
Last updated
09/16/2022
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