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MS. BETH B AVERY LCSW

Professional >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1285658229

Individual Registrant:
MS. BETH B AVERY LCSW
Gender: F
Sole Proprietor

Location and contact information for practice:
5 SCHOOL ST  MYSTIC, CT 06355-2717 US
Tel: 860-572-0667  Fax: 860-572-0667

Contact information for business:
PO BOX 253  OLD MYSTIC, CT 06372-0253 US
Tel: 860-572-0667  Fax: 860-572-0667

Registration Information:
NPI: 1285658229
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YP2500XBehavioral Health & Social Service Providers
Counselor
Professional
CT004996

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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