Provider Demographics
NPI:1497740823
Name:CONANT, BEVERLY ANNE (MA LPC LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ANNE
Last Name:CONANT
Suffix:
Gender:F
Credentials:MA LPC LMFT
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:ANNE
Other - Last Name:BATCHELDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:EAST WAKEFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03830-0531
Mailing Address - Country:US
Mailing Address - Phone:281-961-0807
Mailing Address - Fax:603-522-3312
Practice Address - Street 1:435 ROUTE 1
Practice Address - Street 2:SUITE 2
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-0000
Practice Address - Country:US
Practice Address - Phone:281-961-0807
Practice Address - Fax:603-522-3312
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10354101YP2500X
MECC3532101YP2500X
TX2414106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist