Healthcare Provider Details

I. General information

NPI: 1164898706
Provider Name (Legal Business Name): SUSAN BETH BEARDEN LMHC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2015
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28571 RANCHO MARALENA
LAGUNA NIGUEL CA
92677-7407
US

IV. Provider business mailing address

28571 RANCHO MARALENA
LAGUNA NIGUEL CA
92677-7407
US

V. Phone/Fax

Practice location:
  • Phone: 407-900-8633
  • Fax:
Mailing address:
  • Phone: 407-900-8633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT3040
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH13438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: