Provider Demographics
NPI:1831209964
Name:BEYER, EILEEN PAULA (PSYD)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:PAULA
Last Name:BEYER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:947 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3018
Mailing Address - Country:US
Mailing Address - Phone:610-478-7115
Mailing Address - Fax:610-478-7118
Practice Address - Street 1:947 PENN AVE
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3018
Practice Address - Country:US
Practice Address - Phone:610-478-7115
Practice Address - Fax:610-478-7118
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015208103TA0400X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50031700OtherCAPITAL BLUE CROSS
PA7157674OtherAETNA
PA1420566OtherHIGHMARK BLUE SHIELD
PA2106684000OtherINDEPENDENCE BLUE C ROSS
PA473461000OtherMAGELLAN HEALTH SERVICES
PA067242Medicare ID - Type Unspecified
PAP80900Medicare UPIN