Provider Demographics
NPI:1255917688
Name:BEAM, MARIA (PHD, LMSW)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:BEAM
Suffix:
Gender:F
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4568 TANGLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1184
Mailing Address - Country:US
Mailing Address - Phone:517-505-1493
Mailing Address - Fax:
Practice Address - Street 1:4568 TANGLEWOOD LN
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-1184
Practice Address - Country:US
Practice Address - Phone:517-505-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010892551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical