Provider Demographics
NPI:1831987890
Name:BEAULIEU, ALEC
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:
Last Name:BEAULIEU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 LYNN ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-6471
Mailing Address - Country:US
Mailing Address - Phone:781-299-0490
Mailing Address - Fax:
Practice Address - Street 1:170 LYNN ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-6471
Practice Address - Country:US
Practice Address - Phone:781-299-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician