Individual provider · Type 1 NPI

Timothy Ray Beverly, CDCA

Addiction (Substance Use Disorder) Counselor · Fairborn, OH

NPI number 1194211409 Active

Practice location

302 W Main St
Fairborn, OH 45324-5037

Call (937) 281-4673 Map

Mailing address

100 Crowne Point Place
Cincinnati, OH 45241-5427

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X070488 (OH)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCDCII.161829 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1194211409

Timothy Ray Beverly, CDCA's National Provider Identifier is 1194211409, issued on Jul 10, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fairborn, OH. The record was last updated on Jan 25, 2024.