Provider Demographics
NPI:1831426105
Name:MUSSETTER, BEVERLY ANN (MSW, ACSW, LCSW)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:ANN
Last Name:MUSSETTER
Suffix:
Gender:F
Credentials:MSW, ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W CARMEL DR
Mailing Address - Street 2:STE 120
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5501
Mailing Address - Country:US
Mailing Address - Phone:317-569-5433
Mailing Address - Fax:317-569-1767
Practice Address - Street 1:755 W CARMEL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5877
Practice Address - Country:US
Practice Address - Phone:317-569-5433
Practice Address - Fax:317-569-1767
Is Sole Proprietor?:No
Enumeration Date:2009-11-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003680A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical