Individual
MS. BEVERLY FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY. M, CCBT, CCTS-I
Contact information
Practice address
55 BROOK ST, WOODBRIDGE, NJ 07095-2946
(678) 462-5274
Mailing address
447 BROADWAY STE 443, NEW YORK, NY 10013-2562
(347) 229-9907
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/01/2018
Last updated
05/16/2026
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