Organization
WILLIAM T BEVERLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM T BEVERLY PHD, LCSW (OWNER)
(719) 671-7793
Entity
Organization
Contact information
Practice address
828 W 7TH ST, WALSENBURG, CO 81089-2315
(719) 671-7793
Mailing address
PO BOX 871, WALSENBURG, CO 81089-0871
(719) 671-7793
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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