Mark Alan Beach, LPC

Individual provider Active NPI Professional Counselor · Clarkesville, GA

NPI 1295334209 · NPPES record last updated Oct 21, 2020

Key facts

NPI
1295334209
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC011813 (GA)
Practice address
320 Victory Home LN
Clarkesville, GA 30523
Phone
(706) 754-6030
NPI assigned
Oct 21, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC011813GAMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC011813 GA Yes

Addresses

Primary practice location

320 Victory Home LN
Clarkesville, GA 30523

Mailing address

226 Peachtree St
Colbert, GA 30628-2831
Phone (706) 202-9185

Other identifiers

IdentifierTypeStateIssuer
LPC011813OtherGACOMPOSITE BOARD OF PROFESSIONAL COUNSELORS

Other providers in Clarkesville, GA

All providers in Clarkesville, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.