Provider Demographics
NPI:1578626149
Name:BASKIN, BEVERLY (LPC)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:BASKIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ALBERTA DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1202
Mailing Address - Country:US
Mailing Address - Phone:732-536-0076
Mailing Address - Fax:732-972-8846
Practice Address - Street 1:6 ALBERTA DR
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1202
Practice Address - Country:US
Practice Address - Phone:732-536-0076
Practice Address - Fax:732-972-8846
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00010500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional