Provider Demographics
NPI:1699089565
Name:BEALKO, SARA CATHERINE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:CATHERINE
Last Name:BEALKO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 BERKSHIRE CIR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-8518
Mailing Address - Country:US
Mailing Address - Phone:304-476-5009
Mailing Address - Fax:
Practice Address - Street 1:211 BERKSHIRE CIR
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-8518
Practice Address - Country:US
Practice Address - Phone:304-476-5009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006101235Z00000X
WVSLP-1455235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist