Healthcare Provider Details

I. General information

NPI: 1790463735
Provider Name (Legal Business Name): MICHELLE BEAUDOIN LICENSED PROFESSIONAL CLINICAL COUNSELOR APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6103 ARCHWAY
IRVINE CA
92618-8834
US

IV. Provider business mailing address

6103 ARCHWAY
IRVINE CA
92618-8834
US

V. Phone/Fax

Practice location:
  • Phone: 442-216-6093
  • Fax:
Mailing address:
  • Phone: 442-216-6093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE BEAUDOIN
Title or Position: CEO/FOUNDER
Credential: LPCC, LPC, LMHC
Phone: 442-216-6093