Jennifer R. Beaujon, MA, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC011296 Issued in GA

Practice address

403 Stoney Landing Rd
Moncks Corner, SC 29461-3967

Phone

(770) 873-0464

NPI assigned

Apr 30, 2020

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

• Ms. Jen Beaujon Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 15, 2021.

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1326669490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 STONEY LANDING RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 STONEY LANDING RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967",
            "telephone_number": "770-873-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUJON",
        "first_name": "JENNIFER",
        "middle_name": "R.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC011296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435201",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEN",
            "last_name": "BEAUJON",
            "prefix": "MS.",
            "credential": "JEN BEAUJON MA,LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Moncks Corner, SC
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.