MEDICARE: BEACON WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1215782362
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	205 N LEWIS ST STE A
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-2752
Country	:	US
Telephone Number	:	706-881-3441
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 GREENVILLE ST
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30241-3232
Country	:	US
Telephone Number	:	706-881-3441
Fax Number	:

Authorized Official
Title or Position	:	OWNER/LPC
Name	:	SUJONG CHANG
Credential	:	LPC
Telephone Number	:	706-881-3441

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	03/23/2026

Similar Medicare Providers

1437797453 — SUJONG CHANG MS, LPC
Practice Location Address:

314 GREENVILLE ST
LAGRANGE, GA
30241-3232

Practice Phone: 706-881-3441
Practice Fax:

1437902624 — VITAL CARE HOMECARE AGENCY LLC
Practice Location Address:

314 GREENVILLE ST STE 4
LAGRANGE, GA
30241-3232

Practice Phone: 706-350-3579
Practice Fax:

1316520398 — ROBIN ALLIGOOD NP-C
Practice Location Address:

1075 LAFAYETTE PKWY STE 100
LAGRANGE, GA
30241-3507

Practice Phone: 706-443-5273
Practice Fax:

1023964269 — SHARI KAY DARK-REYNOLDS
Practice Location Address:

229 S DAVIS RD STE 900
LAGRANGE, GA
30241-2609

Practice Phone: 877-848-9810
Practice Fax:

1083560312 — CHELSEA LEIGHANNE HAYES
Practice Location Address:

1015 LAFAYETTE PKWY # 100
LAGRANGE, GA
30241-3584

Practice Phone: 762-842-0221
Practice Fax:

1487509584 — TRUELUX HEALTHCARE LLC
Practice Location Address:

259 ROOKER DR
LAGRANGE, GA
30241-8802

Practice Phone: 762-308-6028
Practice Fax:

Directions to “BEACON WELLNESS CENTER LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.