Provider Demographics
NPI:1487895025
Name:DEAN, BEVERLY (MA NCC LPC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:MA NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-3831
Mailing Address - Country:US
Mailing Address - Phone:973-216-7868
Mailing Address - Fax:
Practice Address - Street 1:1850 US HIGHWAY 46 STE 3
Practice Address - Street 2:
Practice Address - City:LEDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07852-2401
Practice Address - Country:US
Practice Address - Phone:862-244-3551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NJ37PC00435300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health