Healthcare Provider Details

I. General information

NPI: 1326359811
Provider Name (Legal Business Name): BEVERLY JEAN ROBERTS MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2010
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 S BRIDGE ST STE 1
BELDING MI
48809-1765
US

IV. Provider business mailing address

602 E LOWELL ST
LUDINGTON MI
49431-1488
US

V. Phone/Fax

Practice location:
  • Phone: 231-425-8768
  • Fax:
Mailing address:
  • Phone: 231-923-8866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401012952
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: