Beverly Chambers
Individual provider Active NPI Professional Counselor · Centerbrook, CT
NPI 1992375802 · NPPES record last updated Jul 1, 2021
Key facts
- NPI
- 1992375802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 004211 (CT)
- Practice address
- 3 Main St Ste a
Centerbrook, CT 06409-1089 - Phone
- (860) 532-0604
- NPI assigned
- Jul 1, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gilead Community Services, Inc.
Practice addresses (Care Compare)
230 Main St Ext
Middletown, CT 06457-4470
Phone 86034353003421
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250313001036 | CT | Practitioner - Mental Health Counselor | 8527589019 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004211 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gilead Community Services, Inc. | Current |
Accepting new patients |
Locations
230 Main Street Ext
Middletown, CT 06457
Phone (860) 343-5300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 004211 | CT | Yes |
Addresses
Primary practice location
3 Main St Ste a
Centerbrook, CT 06409-1089
Mailing address
25 Clover St
Middletown, CT 06457-5218
Phone (860) 807-6971
Other providers in Centerbrook, CT
- Kathleen Bisson
- Carolyn Reamer Blicharz
- Shirley M Curioso
- Mark Denegre
- Shaun English
- Ernest D. Reamer DMD PC
- Essex Ambulance Association Incorporated
All providers in Centerbrook, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.