Individual provider · Type 1 NPI

Beverly Lake

Counselor · Tucumcari, NM

NPI number 1790099117 Active

Practice location

1110 E High St
Tucumcari, NM 88401-2510

Call (575) 461-4411 Map

Fax (575) 461-4102

Mailing address

10228 State Highway 104
Tucumcari, NM 88401-9315

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

Counselor: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

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About NPI 1790099117

Beverly Lake's National Provider Identifier is 1790099117, issued on Jul 27, 2010. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Tucumcari, NM. The record was last updated on Jul 27, 2010.