Provider Demographics
NPI:1659557460
Name:BEAVER, ELIZABETH LAUREN (BS)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:LAUREN
Last Name:BEAVER
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LAUREN
Other - Last Name:VERDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS
Mailing Address - Street 1:1659 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-3382
Mailing Address - Country:US
Mailing Address - Phone:856-243-5569
Mailing Address - Fax:
Practice Address - Street 1:720 WOODLANE RD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-9615
Practice Address - Country:US
Practice Address - Phone:856-428-7632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health