Individual
SARA NICOLE BEVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
103867
NY
1041C0700X
Clinical Social Worker
093453
NY
1041C0700X
Clinical Social Worker
Primary
15387
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285628552
AGENCY: ANDRUS
—
Enumeration date
07/18/2018
Last updated
11/12/2025
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