Provider Demographics
NPI:1467959320
Name:BEATON, LUCILA (LMSW)
Entity Type:Individual
Prefix:
First Name:LUCILA
Middle Name:
Last Name:BEATON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CROSSCREEK DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4471
Mailing Address - Country:US
Mailing Address - Phone:864-617-1193
Mailing Address - Fax:
Practice Address - Street 1:116 CROSSCREEK DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-4471
Practice Address - Country:US
Practice Address - Phone:864-617-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9039104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker