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Individual

DANIEL RAY BEAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, MAC

Contact information

Practice address
1061 HARMON AVE, STE 1003, FORT STEWART, GA 31314-5641
(912) 435-6633
Mailing address
1061 HARMON AVE, STE 1003, FORT STEWART, GA 31314-5641
(912) 435-6633

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
NAADAC # 507172
101YM0800X
Mental Health Counselor
LPC 004640
GA

Other

Enumeration date
09/16/2006
Last updated
11/10/2011
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