Provider Demographics
NPI:1669466157
Name:RUDEGEAIR, BETH (LCSW, CGP)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:RUDEGEAIR
Suffix:
Gender:F
Credentials:LCSW, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 N DRUID HILLS RD NE
Mailing Address - Street 2:STE. 252
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3192
Mailing Address - Country:US
Mailing Address - Phone:404-325-8003
Mailing Address - Fax:404-325-5310
Practice Address - Street 1:2250 N DRUID HILLS RD NE
Practice Address - Street 2:STE. 252
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-3192
Practice Address - Country:US
Practice Address - Phone:404-325-8003
Practice Address - Fax:404-325-5310
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001997101YA0400X, 103TP2701X, 103T00000X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist