Provider Demographics
NPI:1588890255
Name:BEAUREGARD, RHIANNON CHARLENE (LMFT)
Entity type:Individual
Prefix:MISS
First Name:RHIANNON
Middle Name:CHARLENE
Last Name:BEAUREGARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 W 9TH ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4327
Mailing Address - Country:US
Mailing Address - Phone:603-770-5099
Mailing Address - Fax:
Practice Address - Street 1:2310 W 9TH ST
Practice Address - Street 2:UNIT 1
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-4327
Practice Address - Country:US
Practice Address - Phone:603-770-5099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000735-1106H00000X
MA1402106H00000X
NH142106H00000X
TX202341106H00000X
MEMF3815106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist