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General NPI Number Information
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NPI Number | 1700188489
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Entity Type | Individual
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Provider Name | BEVERLY R SARGENT LGPC
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Gender | Female
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 6608 WILKINS PL
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City | FORESTVILLE
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State | MD
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Zip | 20747-4155
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Country | US
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Telephone | 301-275-6787
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Fax | 301-249-1890
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Provider Business Mailing Address
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Address Line | 1400 GOLDEN EYE COURT
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City | UPPER MARLBORO
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State | MD
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Zip | 20774
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Country | US
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Telephone | 301-275-6787
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Fax | 301-249-1890
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP3017
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number | LGP3017
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License Number State | MD
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