Provider Demographics
NPI:1619026200
Name:LAMPLEY, BEVERLY JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:JEAN
Last Name:LAMPLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411124
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32941-1124
Mailing Address - Country:US
Mailing Address - Phone:321-544-7267
Mailing Address - Fax:
Practice Address - Street 1:1238 AURORA RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5915
Practice Address - Country:US
Practice Address - Phone:321-544-7267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 47281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical