Provider Demographics
NPI:1275395915
Name:BEAVER, BRITTANY SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:SUE
Last Name:BEAVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DANFORD CT
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-6421
Mailing Address - Country:US
Mailing Address - Phone:518-222-6313
Mailing Address - Fax:
Practice Address - Street 1:2 CLARK ST
Practice Address - Street 2:
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1845
Practice Address - Country:US
Practice Address - Phone:518-681-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0968681041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool