Provider Demographics
NPI:1538212667
Name:BEIL, ELIZABETH R (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:R
Last Name:BEIL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5054 DORSEY HALL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7744
Mailing Address - Country:US
Mailing Address - Phone:443-629-3289
Mailing Address - Fax:
Practice Address - Street 1:5054 DORSEY HALL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7744
Practice Address - Country:US
Practice Address - Phone:443-629-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03035103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD375SMedicare ID - Type Unspecified