Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beverley V Theodore, LPC

Individual provider Professional Counselor · NPI 1861076614

Beverley V Theodore, LPC is a Mental Health Counselor in Richmond Hill, Georgia. Qualified in 2015, 11 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
11
Licensed in
GA
In the registry since
2021
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

505 Harris Trail Rd Apt 4H
Richmond Hill, GA 31324-4250
Phone: (404) 944-0525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC012057 (GA)

Record details

NPI number1861076614
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorYes
NPI enumeratedMay 7, 2021
Last updated in NPPESMay 7, 2021
Certification dateMay 7, 2021
Mailing address505 Harris Trail Rd Apt 4h, Richmond Hill, GA 31324-4250

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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