Beverly, Kerri

Beverly, Kerri is an individual health care provider with primary practice located at 1345 Birch Ave , Cottage Grove OR 97424-1416. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Beverly, Kerri can be contacted via phone (541) 520-4915.

Contact Information

Primary practice address
1345 Birch Ave Cottage Grove OR 97424-1416
Phone: (541) 520-4915
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1902200272
LBN Legal business name Beverly, Kerri
Credentials QMHA, PSS
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 15th, 2014
Last updated Aug 21st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902200272 NPPES
Oregon MEDICAID 4353

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