Provider Demographics
NPI:1336279637
Name:RIDENS, BEVERLY SCHELAND (LPC-MHSP, NCC)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:SCHELAND
Last Name:RIDENS
Suffix:
Gender:F
Credentials:LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30575
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-0575
Mailing Address - Country:US
Mailing Address - Phone:865-694-0894
Mailing Address - Fax:865-531-0944
Practice Address - Street 1:8701 TROUTMAN LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37931-4338
Practice Address - Country:US
Practice Address - Phone:865-694-0894
Practice Address - Fax:865-531-0944
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional