Provider Demographics
NPI:1972333813
Name:VELAZQUEZ, BEATRIZ GUADALUPE (MSW)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:GUADALUPE
Last Name:VELAZQUEZ
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 1:2400 CROWNPOINT EXECUTIVE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-6726
Mailing Address - Country:US
Mailing Address - Phone:828-680-0466
Mailing Address - Fax:910-782-2026
Practice Address - Street 1:2400 CROWNPOINT EXECUTIVE DR STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-6726
Practice Address - Country:US
Practice Address - Phone:828-680-0466
Practice Address - Fax:910-782-2026
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO211361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical