Provider Demographics
NPI:1639340649
Name:WILLIAMS, BEVERLY CARTER (MA LPMHC)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:CARTER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA LPMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:NUTRITIONALLY SPEAKING
Mailing Address - City:CHESWOLD
Mailing Address - State:DE
Mailing Address - Zip Code:19936
Mailing Address - Country:US
Mailing Address - Phone:302-678-4909
Mailing Address - Fax:302-678-8944
Practice Address - Street 1:9 E LOOCKERMAN ST
Practice Address - Street 2:STE 315
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901
Practice Address - Country:US
Practice Address - Phone:302-678-4909
Practice Address - Fax:302-678-4944
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC0000056101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional