Beverly Ann Canady

Individual provider Active NPI Professional Counselor · Orange, NJ

NPI 1669010948 · NPPES record last updated Dec 17, 2019

Key facts

NPI
1669010948
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
37PCOO346100 (NJ)
Practice address
116 Main St
Orange, NJ 07050-4059
Phone
(973) 214-0720
NPI assigned
Dec 17, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
37PCOO346100NJMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PCOO346100 NJ Yes

Addresses

Primary practice location

116 Main St
Orange, NJ 07050-4059

Mailing address

106 Lyons Ave
Newark, NJ 07112-2239
Phone (973) 214-4072

Other providers in Orange, NJ

All providers in Orange, NJ · Professional Counselor in New Jersey

Sources for this page

Verify at the official NPI Registry.