Provider Demographics
NPI:1861915159
Name:BEALL, SARAH RENEE (LPE-I)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENEE
Last Name:BEALL
Suffix:
Gender:F
Credentials:LPE-I
Other - Prefix:
Other - First Name:SARAHANN
Other - Middle Name:RENEE
Other - Last Name:BEALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPE-I
Mailing Address - Street 1:10201 W MARKHAM ST STE 342
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2131
Mailing Address - Country:US
Mailing Address - Phone:501-819-3594
Mailing Address - Fax:501-294-2512
Practice Address - Street 1:10201 W MARKHAM ST STE 342
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2131
Practice Address - Country:US
Practice Address - Phone:501-819-3594
Practice Address - Fax:501-294-2512
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR13-31EI103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist