William T Beverly

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WILLIAM T BEVERLY

Practice address

739 1St Ave
Monte Vista, CO 81144-1462

Phone

(719) 671-7793

NPI assigned

Jan 2, 2024

Last updated

Jan 2, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William T Beverly, PHD,LCSWNPI 1184930117

Title

Owner

Phone

(719) 671-7793

Specialties & licenses 3

Addresses

Tax ID family

William T Beverly3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• William T Beverly

  • Adult Mental Health Clinic/Center
  • Alamosa, CO
  • NPI 1699545608
  NPD tax ID
• William T Beverly

  • Adult Mental Health Clinic/Center
  • Trinidad, CO
  • NPI 1811767825
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William Temple Beverly, LCSW, PHD

  • Clinical Social Worker
  • Walsenburg, CO
  • NPI 1184930117
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704153600000",
    "number": "1043080054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 871",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810890871",
            "telephone_number": "719-671-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 1ST AVE",
            "city": "MONTE VISTA",
            "state": "CO",
            "postal_code": "811441462",
            "telephone_number": "719-671-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM T BEVERLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A",
        "authorized_official_last_name": "BEVERLY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-671-7793",
        "authorized_official_credential": "PHD,LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Valley-Wide Health Systems, Inc. (Valley-Wide MERV)
• Vista Care Pharmacy LLC (Vista Care Pharmacy)
• Jennifer Lee Walter, LPC, MA
• Williams Family Chiropractic, PC
• Chad Dee Williams, D.C.
• Cody L Williams, D.C.
• Gerald James Young Jr., RPH
• Vanessa Elizabeth Zwegers, NP-C

• Adult Mental Health Clinic/Center in Monte Vista, CO
• Providers in Monte Vista, CO by specialty
• Adult Mental Health Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.