Provider Demographics
NPI:1154613461
Name:BEAGLE, ABBY RENAE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:RENAE
Last Name:BEAGLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 WARD DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0560
Mailing Address - Country:US
Mailing Address - Phone:615-895-6942
Mailing Address - Fax:615-867-6314
Practice Address - Street 1:1810 WARD DR
Practice Address - Street 2:SUITE 103
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0560
Practice Address - Country:US
Practice Address - Phone:615-895-6942
Practice Address - Fax:615-867-6314
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN70811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical