Provider Demographics
NPI:1235385949
Name:ISENBERG, BEVERLY GERSHON (LPC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:GERSHON
Last Name:ISENBERG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 OLD RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4150
Mailing Address - Country:US
Mailing Address - Phone:203-256-8171
Mailing Address - Fax:
Practice Address - Street 1:132 OLD RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4150
Practice Address - Country:US
Practice Address - Phone:203-256-8171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional