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MS. BETH B AVERY LCSW
Professional >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1285658229
Individual Registrant:MS. BETH B AVERY LCSW
Gender: F
Sole Proprietor
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
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
Tel: 860-572-0667 Fax: 860-572-0667
Registration Information:
NPI: 1285658229
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor Professional | CT | 004996 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
