Provider Demographics
NPI:1205051596
Name:BEAUVAIS, CAROLYN (MSW, ACSW,)
Entity type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:BEAUVAIS
Suffix:
Gender:F
Credentials:MSW, ACSW,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32742 FRIAR TUCK LN
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2500
Mailing Address - Country:US
Mailing Address - Phone:248-644-4989
Mailing Address - Fax:
Practice Address - Street 1:950 E MAPLE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6408
Practice Address - Country:US
Practice Address - Phone:248-646-3294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010044971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical