Provider Demographics
NPI:1831302835
Name:FOTI, BEVERLY MASSEY (LPE)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:MASSEY
Last Name:FOTI
Suffix:
Gender:F
Credentials:LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ROCKY CREST CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-5471
Mailing Address - Country:US
Mailing Address - Phone:501-227-4525
Mailing Address - Fax:
Practice Address - Street 1:225 S PULASKI ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-1925
Practice Address - Country:US
Practice Address - Phone:501-372-2970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR77-35E103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling