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General NPI Number Information
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NPI Number | 1841553799
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Entity Type | Organization
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Legal Business Name | BEAUMONT COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 06/15/2012
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Last Update Date | 06/15/2012
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Provider Practice Location Address
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Address Line | 5211 N TRENHOLM RD
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City | COLUMBIA
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State | SC
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Zip | 29206-4815
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Country | US
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Telephone | 803-422-0035
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Fax |
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Provider Business Mailing Address
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Address Line | 455 VIRGINIA ST
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City | COLUMBIA
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State | SC
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Zip | 29201-4645
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Country | US
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Telephone | 803-422-0035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN DAVID BEAUMONT
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Credential | LPC
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Telephone | 803-422-0035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5017
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5017
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5017
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License Number State | SC
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