Provider Demographics
NPI:1487742052
Name:BEATON, REBECCA ANDREA (PHD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANDREA
Last Name:BEATON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:ANDREA
Other - Last Name:BROGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1640 POWERS FERRY RD SE
Mailing Address - Street 2:BUILDING 9, SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5491
Mailing Address - Country:US
Mailing Address - Phone:770-953-0080
Mailing Address - Fax:770-953-0031
Practice Address - Street 1:1640 POWERS FERRY RD SE
Practice Address - Street 2:BUILDING 9, SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-5491
Practice Address - Country:US
Practice Address - Phone:770-953-0080
Practice Address - Fax:770-953-0031
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002789103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling