Provider Demographics
NPI:1639510381
Name:BEARDEN, ALLISON HEATHER (LPC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:HEATHER
Last Name:BEARDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 DAHLONEGA ST STE A1902
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-8220
Mailing Address - Country:US
Mailing Address - Phone:770-322-4624
Mailing Address - Fax:
Practice Address - Street 1:327 DAHLONEGA ST STE A1902
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8220
Practice Address - Country:US
Practice Address - Phone:770-322-4624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-10
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008307101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional