Provider Demographics
NPI:1992088553
Name:BEAUMONT, ROBIN (PHD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 CALIFORNIA RD UNIT 913
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-6536
Mailing Address - Country:US
Mailing Address - Phone:267-888-2599
Mailing Address - Fax:844-304-9317
Practice Address - Street 1:1534 W BROAD ST STE 600
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1050
Practice Address - Country:US
Practice Address - Phone:267-888-2599
Practice Address - Fax:844-304-9317
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1027456840001Medicaid
PA229569ZFTQMedicare PIN
PA229569ZM5UMedicare PIN