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Organization
DRBEV MENTAL HEALTH COUNSELING LLC
Active
Organization
DRBEV MENTAL HEALTH COUNSELING LLC
Active
Other names
BEVERLY JACKSON
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY JACKSON LMHC (OWNER)
(813) 434-3705
Entity
Organization
Contact information
Practice address
9800 4TH ST N, SUITE 200, ST PETERSBURG, FL 33702-2417
(203) 695-3015
Mailing address
9800 4TH ST N, SUITE 200, ST PETERSBURG, FL 33702-2417
(203) 695-3015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009977500
—
FL
Enumeration date
05/03/2017
Last updated
05/03/2017
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