Provider Demographics
NPI:1740419720
Name:HARJU, BEVERLY LONG (PHD)
Entity type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:LONG
Last Name:HARJU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BEVERLY
Other - Middle Name:BATTENBERG
Other - Last Name:HARJU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:308 KING GEORGE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5616
Mailing Address - Country:US
Mailing Address - Phone:252-258-1212
Mailing Address - Fax:
Practice Address - Street 1:308 KING GEORGE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5616
Practice Address - Country:US
Practice Address - Phone:252-258-1212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1949103TC0700X
CAPB6218103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical