Provider Demographics
NPI:1841281656
Name:HIME, BEVERLY A (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:A
Last Name:HIME
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 PAT BOOKER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-4154
Mailing Address - Country:US
Mailing Address - Phone:210-723-8309
Mailing Address - Fax:830-980-4463
Practice Address - Street 1:1001 PAT BOOKER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-4154
Practice Address - Country:US
Practice Address - Phone:210-723-8309
Practice Address - Fax:830-980-4463
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health