Healthcare Provider Details

I. General information

NPI: 1427977206
Provider Name (Legal Business Name): OLIVIA GRACE BEAUPRE MS, LCMHCA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GREEN VALLEY RD
GREENSBORO NC
27408-7700
US

IV. Provider business mailing address

1 WINDROCK WAY
GREENSBORO NC
27455-2258
US

V. Phone/Fax

Practice location:
  • Phone: 919-300-6717
  • Fax:
Mailing address:
  • Phone: 336-686-6874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA20698
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: