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Individual

MR. MARK ALAN BEACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
320 VICTORY HOME LN, CLARKESVILLE, GA 30523
(706) 754-6030
Mailing address
226 PEACHTREE ST, COLBERT, GA 30628-2831
(706) 202-9185

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC011813
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LPC011813
COMPOSITE BOARD OF PROFESSIONAL COUNSELORS
GA
Enumeration date
10/21/2020
Last updated
10/21/2020
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