| Doctor Name: | JOHN A. BEACH |
| NPI Number: | 1811104243 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED. |
| License Number: | 495 |
| Business Practice Address: | 923 Route 6a Building 7, 2nd Floor Yarmouth Port, MA - 026752159 |
| Business Phone Number: | 5083627692 |
| Business Fax Number: | |
| Mailing Address: | 923 Route 6a, P.o. Box 524 YARMOUTH PORT |
| State: | MA |
| Postal Code: | 026752159 |
| Phone Number: | 5083627692 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 495 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |