Provider Demographics
NPI:1659418127
Name:SIVLEY, BEVERLY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:
Last Name:SIVLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:DAWN
Other - Last Name:SALVATORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:428 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-4803
Mailing Address - Country:US
Mailing Address - Phone:270-985-8323
Mailing Address - Fax:270-885-6866
Practice Address - Street 1:650 JOEL DRIVE
Practice Address - Street 2:DEPT. OF BEHAVIORAL HEALTH
Practice Address - City:FORT CAMPBELL, KY
Practice Address - State:KY
Practice Address - Zip Code:42223-5349
Practice Address - Country:US
Practice Address - Phone:270-956-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical