Provider Demographics
NPI:1386866341
Name:KING, BEVERLY (LPCS)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARDINAL RD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-5204
Mailing Address - Country:US
Mailing Address - Phone:336-209-8336
Mailing Address - Fax:
Practice Address - Street 1:800 CARDINAL RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5204
Practice Address - Country:US
Practice Address - Phone:252-633-3855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional