Provider Demographics
NPI:1770714487
Name:LYNN M. BEVER LLC
Entity type:Organization
Organization Name:LYNN M. BEVER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-239-0598
Mailing Address - Street 1:610 N MAIN ST STE 259
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-3311
Mailing Address - Country:US
Mailing Address - Phone:540-239-0598
Mailing Address - Fax:540-961-2694
Practice Address - Street 1:610 N MAIN ST STE 259
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-3311
Practice Address - Country:US
Practice Address - Phone:540-239-0598
Practice Address - Fax:540-961-2694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003961103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMC12073Medicare PIN