Provider Demographics
NPI:1780189035
Name:BEAM, VICKIE LYNNE (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:LYNNE
Last Name:BEAM
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:LYNNE
Other - Last Name:NECESSARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:WASHINGTON COUNTY PUBLIC SCHOOLS
Mailing Address - Street 2:812 THOMPSON DRIVE
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210
Mailing Address - Country:US
Mailing Address - Phone:276-739-3043
Mailing Address - Fax:
Practice Address - Street 1:WASHINGTON COUNTY PUBLIC SCHOOLS
Practice Address - Street 2:812 THOMPSON DRIVE
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-739-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1602235Z00000X
VA220202000187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist