Beverly A Haverly, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2026-123 Issued in WI

Practice address

1035 N Main St
Rice Lake, WI 54868-1260

Phone

(715) 234-4313

Fax

(715) 736-0194

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Hills Counseling LLC

  • Mental Health Counselor
  • Rice Lake, WI
  • NPI 1265406227
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1386707115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681260",
            "telephone_number": "715-234-4313",
            "fax_number": "715-736-0194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 N MAIN ST",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681260",
            "telephone_number": "715-234-4313",
            "fax_number": "715-736-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERLY",
        "first_name": "BEVERLY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "2026-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39232800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Hand
• Debra K. Hanson, LPN
• Tracey Lynn Harris, DNP
• Kathleen Hartman, PT, DPT
• Jenny A. Hastreiter, PT
• Healthstat Health Center Rice Lake
• Jaquelyn Healy
• Patrick M Healy, MD
• Christina Marie Heddinger
• Aaron M Hendricks

• Mental Health Counselor in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.