Provider Demographics
NPI:1346360195
Name:ALLEN, BEVERLY D (LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 WHITE STREET
Mailing Address - Street 2:#7
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040
Mailing Address - Country:US
Mailing Address - Phone:306-609-2448
Mailing Address - Fax:
Practice Address - Street 1:818 WHITE STREET
Practice Address - Street 2:#7
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040
Practice Address - Country:US
Practice Address - Phone:306-609-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001644A101YM0800X
FLMH4938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100065860AJMedicaid