Healthcare Provider Details

I. General information

NPI: 1477866085
Provider Name (Legal Business Name): PAUL VINCENT BEIRNE LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 06/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3098 CALIFORNIA ST # 26
SAN FRANCISCO CA
94115-2469
US

IV. Provider business mailing address

3098 CALIFORNIA ST # 26
SAN FRANCISCO CA
94115-2469
US

V. Phone/Fax

Practice location:
  • Phone: 415-847-5826
  • Fax:
Mailing address:
  • Phone: 415-847-5826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC 412
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC 412
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 10629
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: