Active NPI
Dequarius Beverly
- Counselor
- Las Vegas, NV
National Provider Identifier
1629314612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 5330 E Charleston Blvd Unit 132
Las Vegas, NV 89142-1063 - Phone
- (702) 462-0154
- NPI assigned
- Dec 18, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
5330 E Charleston Blvd Unit 132
Las Vegas, NV 89142-1063
Mailing address
5330 E Charleston Blvd Unit 132
Las Vegas, NV 89142-1063
Phone (702) 462-0154
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355788800000",
"number": "1629314612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5330 E CHARLESTON BLVD UNIT 132",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891421063",
"telephone_number": "702-462-0154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5330 E CHARLESTON BLVD UNIT 132",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891421063",
"telephone_number": "702-462-0154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEVERLY",
"first_name": "DEQUARIUS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-18",
"last_updated": "2012-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.