Provider Demographics
NPI:1710686167
Name:EMILY BEALL LLC
Entity Type:Organization
Organization Name:EMILY BEALL LLC
Other - Org Name:EMILY BEALL, M.ED LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:BEALL
Authorized Official - Suffix:
Authorized Official - Credentials:MED LPC
Authorized Official - Phone:706-210-2767
Mailing Address - Street 1:2826 HILLCREEK DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-5628
Mailing Address - Country:US
Mailing Address - Phone:706-210-2767
Mailing Address - Fax:762-222-1094
Practice Address - Street 1:2826 HILLCREEK DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-5628
Practice Address - Country:US
Practice Address - Phone:706-210-2767
Practice Address - Fax:762-222-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty