Provider Demographics
NPI:1265159594
Name:SABLE, BEVERLY DANIELLE MCCAY (LPC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:DANIELLE MCCAY
Last Name:SABLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:BEVERLY
Other - Middle Name:KAY
Other - Last Name:MCCAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10803 KIAMICHI DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-7431
Mailing Address - Country:US
Mailing Address - Phone:903-245-4799
Mailing Address - Fax:
Practice Address - Street 1:2624 KENSINGTON DR STE 112
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-2734
Practice Address - Country:US
Practice Address - Phone:903-630-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional