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Individual
ROBERT BEACH III
Active
Individual
ROBERT BEACH III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
180008467
IL
101YM0800X
Mental Health Counselor
Primary
180008467
IL
Other
Enumeration date
02/25/2013
Last updated
07/20/2023
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