Eagan Beverly, Suzanne M

Eagan Beverly, Suzanne M is an sole proprietor health care provider with primary practice located at 875 Mass Ave Ste 25 , Cambridge MA 02139-3067. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Dance Therapist. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Eagan Beverly, Suzanne M can be contacted via phone (781) 790-6369.

Contact Information

Primary practice address
875 Mass Ave Ste 25 Cambridge MA 02139-3067
Phone: (781) 790-6369
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 7965 Massachusetts
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Dance Therapist 225600000X BC-DMT 1060 Massachusetts

Profile Details

NPI number 1134251036
LBN Legal business name Eagan Beverly, Suzanne M
Credentials LMHC, BC-DMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Jul 2nd, 2013 - about 11 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 1134251036 NPPES
Massachusetts Other 1060 AMERICAN DANCE MOVEMENT THERAPY ASSOCIATION

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