Individual
JILLIAN N BEAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
763-765 NOSTRAND AVE,, STE#1, BROOKLYN, NY 11216
(718) 230-8600
(718) 228-2013
Mailing address
763-765 NOSTRAND AVE, STE#1, BROOKLYN, NY 11216
(718) 230-8600
(718) 228-2013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
06681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26681
LICENSE
NY
Enumeration date
08/16/2018
Last updated
08/16/2018
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