BRENDA BEVERLY (NPI# 1043608680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043608680 |
| Entity Type | Individual |
| Full Name | BRENDA BEVERLY |
| Credential | CADC |
| Practice Address |
1190 West 1190 West Suite 812 Jackson MI 49202 |
| Mailing Address |
3817 Lone Pine Dr Apt 2 Holt MI 48842-8800 |
| Practice Telephone | 5175133657 |
| Practice Fax Number | 5175133693 |
| Mailing Telephone | 9892331020 |
| Enumeration Date | 2015-01-06 |
| Last Update Date | 2015-01-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2-00945 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326108283 | Brenda Lee Beverly | Speech-Language Pathologist | 5721 Usa North Dr, Hahn 1119, Mobile, AL 36688-0002 | 2006-12-11 |
| Street Address |
1190 WEST 1190 WEST SUITE 812 |
| City | JACKSON |
| State | MI |
| Zip Code | 49202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| 1083941058 | Brenda Lynn Spalding | Respite Care | 817 Fairyland Ave, Jackson, MI 49202 | 2009-11-11 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952665 | John Cate Owen | Counselor | 2525 Lakeward Dr Ste 400, Jackson, MS 39216-4827 | 2020-11-04 |
| 1760098727 | Anna Marie Jones | Counselor | 32 Portsmouth St, Jackson, OH 45640-1622 | 2020-09-16 |
| 1891313656 | Kayla Lynn Fazzari | Counselor | N168w20964 Main St, Jackson, WI 53037-9634 | 2020-07-08 |
| 1184184202 | Tracy Dawn Schuh | Counselor | 300 Morton St, Jackson, OH 45640-1028 | 2019-03-24 |
| 1013483858 | Bradley A Tompson | Counselor | 794 Mcdonough Rd Ste 100, Jackson, GA 30233-1572 | 2018-10-19 |
| 1295237048 | Impact Behavioral Counseling LLC | Counselor | 37 Sandstone Cir Ste 92b, Jackson, TN 38305-2089 | 2018-03-07 |
| 1942708920 | Candace R Downey | Counselor | 120 Twin Oaks Dr Unit D, Jackson, OH 45640-9506 | 2018-01-25 |
| 1508379462 | Vicki Lee Harper | Counselor | 295 Broadway St Ste 101, Jackson, OH 45640-1701 | 2017-11-14 |
| 1356867295 | Stephanie Michelle Gilbert | Counselor | 345 E Main St Ste A, Jackson, OH 45640-1780 | 2017-08-22 |
| 1477081206 | Trending Upwards | Counselor | 1754 Highway 15 N, Jackson, KY 41339 | 2017-05-24 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.