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General NPI Number Information
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NPI Number | 1063792463
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Entity Type | Individual
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Provider Name | BEVERLY JUNE COURSEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR B7500 FORT CARSON
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City | COLORADO SPRINGS
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State | CO
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Zip | 80913-4603
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Country | US
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Telephone | 719-503-7869
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Fax |
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Provider Business Mailing Address
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Address Line | 6755 DELMONICO DR APT 303
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1339
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Country | US
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Telephone | 808-346-9743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS12613
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW 3449
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License Number State | HI
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