Provider Demographics
NPI:1275660094
Name:TAUKE, BEVERLY HUBBLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:HUBBLE
Last Name:TAUKE
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 1:1405 GREENWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1604
Mailing Address - Country:US
Mailing Address - Phone:703-823-8993
Mailing Address - Fax:703-823-8994
Practice Address - Street 1:10372 DEMOCRACY LN
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2522
Practice Address - Country:US
Practice Address - Phone:703-591-2551
Practice Address - Fax:703-591-2563
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical