Provider Demographics
NPI:1184767691
Name:PACOS, BEVERLY LINN (MED, NCC, LPC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:LINN
Last Name:PACOS
Suffix:
Gender:F
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 HANNA LN
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9093
Mailing Address - Country:US
Mailing Address - Phone:919-524-0015
Mailing Address - Fax:
Practice Address - Street 1:4000 BLUE RIDGE RD
Practice Address - Street 2:STE. 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4650
Practice Address - Country:US
Practice Address - Phone:919-782-4981
Practice Address - Fax:919-782-2474
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6765101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional