Provider Demographics
NPI:1497199616
Name:BEEBE, GEORGIA LYNN (CADC-1)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:LYNN
Last Name:BEEBE
Suffix:
Gender:F
Credentials:CADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3698 GYPSUM RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-1238
Mailing Address - Country:US
Mailing Address - Phone:775-800-1234
Mailing Address - Fax:
Practice Address - Street 1:3698 GYPSUM RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-1238
Practice Address - Country:US
Practice Address - Phone:775-800-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC5220112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)