Provider Demographics
NPI:1073907705
Name:ROBIN BEAUMONT PHD LLC
Entity Type:Organization
Organization Name:ROBIN BEAUMONT PHD LLC
Other - Org Name:CROSSROADS THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEAUMONT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:267-888-2599
Mailing Address - Street 1:1783 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-5713
Mailing Address - Country:US
Mailing Address - Phone:267-888-2599
Mailing Address - Fax:800-852-2549
Practice Address - Street 1:628 JUNIPER ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1587
Practice Address - Country:US
Practice Address - Phone:267-888-2599
Practice Address - Fax:800-851-2549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty