Provider Demographics
NPI:1083794853
Name:BEAUDEAU, ALAIN CHARLES (MS, MA)
Entity Type:Individual
Prefix:MR
First Name:ALAIN
Middle Name:CHARLES
Last Name:BEAUDEAU
Suffix:
Gender:M
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-3034
Mailing Address - Country:US
Mailing Address - Phone:516-775-1468
Mailing Address - Fax:516-775-0443
Practice Address - Street 1:1031 N 7TH ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-3034
Practice Address - Country:US
Practice Address - Phone:516-775-1468
Practice Address - Fax:516-775-0443
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003415-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health