Healthcare Provider Details

I. General information

NPI: 1326137043
Provider Name (Legal Business Name): BEVERLY DIANE VCHULEK MS,MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2068 HEALTH CARE AVE
NAVARRE FL
32566-2901
US

IV. Provider business mailing address

3510 CHIEF MATE DR
PENSACOLA FL
32506-9688
US

V. Phone/Fax

Practice location:
  • Phone: 850-791-0885
  • Fax:
Mailing address:
  • Phone: 850-637-3986
  • Fax: 850-637-1178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH00003448
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: