person
Beverly Fairhurst, MA,LCMHC,LCDP
Mental Health Counselor in East Providence, Rhode Island
NPI 1992780449

Beverly Fairhurst is a Mental Health Counselor based in Pawtucket, RI and is specialized in Mental Health. Beverly Fairhurst practices in East Providence, RI and has the professional credentials of MA,LCMHC,LCDP. The NPI Number for Beverly Fairhurst is 1992780449 and holds a License No. 00027 (Rhode Island).

The current practice location address for Beverly Fairhurst is 610 Wampanoag Trl, East Providence, RI and can be reached out via phone at 401-431-9870 and via fax at 401-435-7486. You can also correspond with Beverly Fairhurst through the mailing address at 7 ROCCO AVE, PAWTUCKET, RI - 02860-5822 (mailing address contact number: 401-725-2278).

Location: 610 Wampanoag Trl, East Providence, RI, 02860-5822
person
Provider Profile Details
NPI Number
1992780449
Provider Name
Beverly Fairhurst
Credential
MA,LCMHC,LCDP
Provider Entity Type
Individual
Gender
Female
Address
610 Wampanoag Trl, East Providence, RI, 02860-5822
Phone Number
401-431-9870
Fax Number
401-435-7486
Provider Enumeration Date
12/07/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
406396 01 RI BLUE CHIP
BF15322 05 RI
30016-6 01 RI BLUE CROSS
62-34366 01 RI UNITED
institution
Provider Business Practice Location Address Details
Address
610 Wampanoag Trl
City
State
Zip
02915-1504
Phone Number
401-431-9870
Fax Number
401-435-7486
person
Provider Business Mailing Address Details
Address
7 Rocco Ave
City
State
Zip
02860-5822
Phone Number
401-725-2278
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
80 (Rhode Island)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
00027 (Rhode Island)
Definition
Definition to come...
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