Provider Demographics
NPI:1922678341
Name:BEAUMONT, CHRISTOPHER GEORGE
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GEORGE
Last Name:BEAUMONT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 SUBURBAN RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7429
Mailing Address - Country:US
Mailing Address - Phone:973-255-9937
Mailing Address - Fax:
Practice Address - Street 1:756 SUBURBAN RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7429
Practice Address - Country:US
Practice Address - Phone:973-255-9937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling