Provider Demographics
NPI:1619953189
Name:VORIS, BEVERLY J (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:J
Last Name:VORIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 W LINCOLN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-2453
Mailing Address - Country:US
Mailing Address - Phone:217-348-3334
Mailing Address - Fax:217-348-3336
Practice Address - Street 1:506 W LINCOLN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-2453
Practice Address - Country:US
Practice Address - Phone:217-348-3334
Practice Address - Fax:217-348-3336
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional