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General NPI Number Information
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NPI Number | 1710686167
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Entity Type | Organization
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Legal Business Name | EMILY BEALL LLC
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 4434 COLUMBIA RD STE 201
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City | MARTINEZ
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State | GA
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Zip | 30907-4282
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Country | US
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Telephone | 706-305-4928
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Fax |
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Provider Business Mailing Address
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Address Line | 4434 COLUMBIA RD STE 201
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City | MARTINEZ
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State | GA
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Zip | 30907-4282
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Country | US
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Telephone | 706-305-4928
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | EMILY BEALL
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Credential | M.ED LPC
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Telephone | 706-305-4928
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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