Provider Demographics
NPI:1710043070
Name:NEVINS, AUDREY BEYERS (MS,LPC)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:BEYERS
Last Name:NEVINS
Suffix:
Gender:F
Credentials:MS,LPC
Other - Prefix:MS
Other - First Name:AUDREY
Other - Middle Name:BEYERS
Other - Last Name:TOMASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1200 HOSFORD ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-9316
Mailing Address - Country:US
Mailing Address - Phone:715-381-1980
Mailing Address - Fax:715-381-1906
Practice Address - Street 1:1200 HOSFORD ST STE 107
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-9316
Practice Address - Country:US
Practice Address - Phone:715-381-1980
Practice Address - Fax:715-381-1906
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3269-125101YP2500X
MN00227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional