Provider Demographics
NPI:1902231566
Name:BEVIER, JESSICA N
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:BEVIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:N
Other - Last Name:BEVIER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:796 W GENESEE STREET RD
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-9311
Mailing Address - Country:US
Mailing Address - Phone:315-730-3503
Mailing Address - Fax:
Practice Address - Street 1:796 W GENESEE STREET RD
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-9311
Practice Address - Country:US
Practice Address - Phone:315-730-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP84711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health