Beverley Banks Watkins, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149004814 Issued in IL

Practice address

2014 Vandalia St
Collinsville, IL 62234-4848

Phone

(618) 345-9536

Fax

(618) 345-9587

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Promed Preferred Il 2 PLLCGroup PAC ID 3870028251, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Promed Preferred Il 2 PLLC

  • Clinical Social Worker
  • Fairview Heights, IL
  • NPI 1023855566
  Medicare reassignment Care Compare group NPD
• Family Life Consultants, Inc

  • Psychologist
  • Collinsville, IL
  • NPI 1164532248
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568583136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 MEADOW LN",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620255520",
            "telephone_number": "618-692-0343",
            "fax_number": "618-692-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 VANDALIA ST",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344848",
            "telephone_number": "618-345-9536",
            "fax_number": "618-345-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "BEVERLEY",
        "middle_name": "BANKS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149004814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana L Wall- Dudley, LCSW
• Kimberly D Wallace, SLP
• Walmart Inc
• Walmart Inc.
• Kimberly A Washburn, MSW
• Weber Chiropractic Centers LLC
• Chad Brian Weber, D.C.
• Ronald Dean Weems Jr., D.M.D
• Judith L Weiss, RPH
• William C Weissert, PT

• Clinical Social Worker in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.