Provider Demographics
NPI:1356440267
Name:GIBEL, BEVERLY (LCSW,ACSW,PA)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:GIBEL
Suffix:
Gender:F
Credentials:LCSW,ACSW,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 VILLAGE BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1960
Mailing Address - Country:US
Mailing Address - Phone:561-684-8335
Mailing Address - Fax:561-686-2580
Practice Address - Street 1:580 VILLAGE BLVD STE 370
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1960
Practice Address - Country:US
Practice Address - Phone:561-684-8335
Practice Address - Fax:561-686-2580
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00032771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5519OtherBLUE CROSS/BLUE SHIELD
FLZ5519OtherBLUE CROSS/BLUE SHIELD