# SARA NICOLE BEVERLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1720564123
- **Gender:** F
- **Credential:** LCSW

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 103867 | NY | — |
| 1041C0700X | Clinical Social Worker | 093453 | NY | — |
| 1041C0700X | Clinical Social Worker | 15387 | SC | Yes |

## Other

- **Enumeration date:** 07/18/2018
- **Last updated:** 11/12/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1285628552 | AGENCY: ANDRUS | — |