BEVERLY FAIRHURST M.A. LCMHC LCDP NPI 1992780449

NPI Information

NPI: 1992780449
Provider Name: BEVERLY FAIRHURST, M.A., LCMHC, LCDP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
610 WAMPANOAG TRL
EAST PROVIDENCE, RI
ZIP 02915
Phone: (401) 431-9870
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Beverly Fairhurst, M.A., LCMHC, LCDP is an addiction (substance use disorder) counselor in East Providence, RI. Beverly Fairhurst, M.A., LCMHC, LCDP NPI is 1992780449. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

610 WAMPANOAG TRL
EAST PROVIDENCE, RI
ZIP 02915-504
Phone: (401) 431-9870
Fax: (401) 435-7486

The enumeration date for this NPI number is 12/7/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	00027	RHODE ISLAND	Yes
2	101YM0800X	Counselor	Mental Health	80	RHODE ISLAND	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	BF15322	MEDICAID	RHODE ISLAND
2	62-34366	OTHER	RHODE ISLAND	UNITED
3	30016-6	OTHER	RHODE ISLAND	BLUE CROSS
4	406396	OTHER	RHODE ISLAND	BLUE CHIP

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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