Provider Demographics
NPI:1366922718
Name:FORCONI-BEACH, AMY (LPC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FORCONI-BEACH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1041
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1041
Mailing Address - Country:US
Mailing Address - Phone:541-205-9290
Mailing Address - Fax:541-610-1692
Practice Address - Street 1:2955 N HWY 97
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7559
Practice Address - Country:US
Practice Address - Phone:541-205-9290
Practice Address - Fax:541-610-1692
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional