Organization
BEALL & ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BYRON FRANK BEALL LCSW. BCBA (PRESIDENT)
(904) 556-2169
Entity
Organization
Contact information
Practice address
961687 GATEWAY BLVD, SUITE 201 N, FERNANDINA BEACH, FL 32034-9157
(904) 277-8999
Mailing address
PO BOX 16837, FERNANDINA BEACH, FL 32035-3131
(904) 556-2169
(904) 206-4174
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BCBA 1010451
FL
251S00000X
Community/Behavioral Health Agency
Primary
SW 5260
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
692499996
—
FL
05
—
692499998
—
FL
Enumeration date
12/14/2009
Last updated
05/11/2010
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