Provider Demographics
NPI:1386664712
Name:WALTERS, BEVERLY KAY (MSW)
Entity type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:KAY
Last Name:WALTERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 N 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2509
Mailing Address - Country:US
Mailing Address - Phone:804-458-2166
Mailing Address - Fax:
Practice Address - Street 1:211 N 5TH AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2509
Practice Address - Country:US
Practice Address - Phone:804-458-2166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040002841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical