Individual
BEAKIE JORELISSE COLON RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA, LCAS
Contact information
Practice address
9317 58TH AVENUE CT SW APT Q302, LAKEWOOD, WA 98499-6104
(910) 587-9432
Mailing address
9317 58TH AVENUE CT SW APT Q302, LAKEWOOD, WA 98499-6104
(910) 587-9432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-23687
NC
1041C0700X
Clinical Social Worker
Primary
P011751
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCAS-23687
NORTH CAROLINA LCAS
NC
01
—
P011715
NORTH CAROLINA LCSWA
NC
Enumeration date
06/29/2017
Last updated
01/14/2020
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