Provider Demographics
NPI:1386420214
Name:BEACH, MATTHEW ALEXANDER (MS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALEXANDER
Last Name:BEACH
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 RUSTLEAF LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-1421
Mailing Address - Country:US
Mailing Address - Phone:856-449-9568
Mailing Address - Fax:
Practice Address - Street 1:14 RUSTLEAF LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1421
Practice Address - Country:US
Practice Address - Phone:856-449-9568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst