Provider Demographics
NPI:1912063710
Name:BEAUMONT, DEBRA SCHILD (LMHC)
Entity type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:SCHILD
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 SAINT HELENA ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:NY
Mailing Address - Zip Code:14530-9527
Mailing Address - Country:US
Mailing Address - Phone:585-237-3983
Mailing Address - Fax:
Practice Address - Street 1:59 LEICESTER ST
Practice Address - Street 2:THE CENTER - SUITE 110
Practice Address - City:PERRY
Practice Address - State:NY
Practice Address - Zip Code:14530-1155
Practice Address - Country:US
Practice Address - Phone:585-237-2764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
001866-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health