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Organization
DRBEV MENTAL HEALTH COUNSELING LLC
Active
Organization
DRBEV MENTAL HEALTH COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEVERLY JACKSON LMHC (LICENSED MENTAL HEALTH COUNSELOR)
(727) 201-5460
Entity
Organization
Contact information
Practice address
9800 4TH ST N STE 200, ST PETERSBURG, FL 33702-2462
(727) 201-5460
(727) 214-1977
Mailing address
9800 4TH ST N STE 200, ST PETERSBURG, FL 33702-2462
(727) 201-5460
(727) 214-1977
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH8038
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009977500
—
FL
Enumeration date
10/27/2016
Last updated
10/27/2016
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