Provider Demographics
NPI:1114188786
Name:BEARD, GEORGIA ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:ANN
Last Name:BEARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 BOWERS ST
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-6231
Mailing Address - Country:US
Mailing Address - Phone:903-245-0349
Mailing Address - Fax:
Practice Address - Street 1:317 BOWERS ST
Practice Address - Street 2:
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-6231
Practice Address - Country:US
Practice Address - Phone:903-245-0349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62097101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional