Provider Demographics
NPI:1891046637
Name:CHEN, BEVERLY HSIAO LIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:HSIAO LIN
Last Name:CHEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 S SAN GABRIEL BLVD APT 1
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-6644
Mailing Address - Country:US
Mailing Address - Phone:909-519-6102
Mailing Address - Fax:
Practice Address - Street 1:911 E COLORADO BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1773
Practice Address - Country:US
Practice Address - Phone:909-519-6102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health