Individual
BEVERLY EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
103 BRENTWOOD CENTER LN N, WILSON, NC 27896-1710
(252) 293-9966
(252) 293-9967
Mailing address
PO BOX 7626, WILSON, NC 27895-7626
(252) 293-9966
(252) 293-9967
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C003025
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0706F
NC HEALTH CHOICE
NC
01
—
186590
MANAGED HEALTH NETWORK
NC
01
—
22143300
MEGELLAN HEALTH
NC
05
—
6002010
—
NC
Enumeration date
09/15/2006
Last updated
07/09/2007
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