Provider Demographics
NPI:1437537677
Name:CONE, BEVERLY ANN (MA MFT)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:CONE
Suffix:
Gender:F
Credentials:MA MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 OLD STAGE RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-1372
Mailing Address - Country:US
Mailing Address - Phone:541-778-8149
Mailing Address - Fax:
Practice Address - Street 1:2708 OLD STAGE RD
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-1372
Practice Address - Country:US
Practice Address - Phone:541-778-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMFT TO813106H00000X
CAMFT24851106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFT 24851OtherCA MFT LICENSE #
ORMFT TO813OtherOR MFT LICENSE #