Provider Demographics
NPI:1639297955
Name:PIERCE, BEVERLY D (MA, LCSW)
Entity Type:Individual
Prefix:
First Name:BEVERLY
Middle Name:D
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OLD MAMARONECK RD
Mailing Address - Street 2:SUITE 1L
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1750
Mailing Address - Country:US
Mailing Address - Phone:914-682-6690
Mailing Address - Fax:914-682-6690
Practice Address - Street 1:5 OLD MAMARONECK RD
Practice Address - Street 2:SUITE 1L
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1750
Practice Address - Country:US
Practice Address - Phone:914-682-6690
Practice Address - Fax:914-682-6690
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0434251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical