Provider Demographics
NPI:1811310618
Name:BEAUMONT, BETTY J (LPC)
Entity type:Individual
Prefix:MISS
First Name:BETTY
Middle Name:J
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BETTY
Other - Middle Name:JANE
Other - Last Name:HUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NONE
Mailing Address - Street 1:220 S PINE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759-1679
Mailing Address - Country:US
Mailing Address - Phone:480-329-2495
Mailing Address - Fax:
Practice Address - Street 1:220 S PINE ST STE 201
Practice Address - Street 2:
Practice Address - City:SISTERS
Practice Address - State:OR
Practice Address - Zip Code:97759-1679
Practice Address - Country:US
Practice Address - Phone:480-329-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health