Provider Demographics
NPI:1467406587
Name:PERRY, BEVERLY M
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:M
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N. MAGNOLIA ST.
Mailing Address - Street 2:SWCMHC
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1946
Mailing Address - Country:US
Mailing Address - Phone:803-775-9364
Mailing Address - Fax:803-773-6615
Practice Address - Street 1:764 WEST LIBERTY ST.
Practice Address - Street 2:2 MEDICAL CT., SWCMHC/ACT
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29151-1946
Practice Address - Country:US
Practice Address - Phone:803-778-4195
Practice Address - Fax:803-778-6598
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health