Beazley, Jonathan C

Beazley, Jonathan C is an sole proprietor health care provider with primary practice located at 384 Merrow Rd Ste D , Tolland CT 06084-3957. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Beazley, Jonathan C can be contacted via phone (860) 875-2578.

Contact Information

Primary practice address
384 Merrow Rd Ste D Tolland CT 06084-3957
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 000631 Connecticut

Profile Details

NPI number 1619185469
LBN Legal business name Beazley, Jonathan C
Credentials LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619185469 NPPES
Connecticut Other 410000631CT02 ANTHEM BLUE CROSS

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