Provider Demographics
NPI:1598758773
Name:BEBEAU, JAMES FREDRICK (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FREDRICK
Last Name:BEBEAU
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:245 HAIRSTON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-4137
Mailing Address - Country:US
Mailing Address - Phone:434-799-0456
Mailing Address - Fax:434-793-4201
Practice Address - Street 1:245 HAIRSTON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4137
Practice Address - Country:US
Practice Address - Phone:434-799-0456
Practice Address - Fax:434-793-4201
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003319101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional