Provider Demographics
NPI:1861695934
Name:HERVEY DUREN, BETH ANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANNE
Last Name:HERVEY DUREN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 REDHILL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPLAY
Mailing Address - State:CO
Mailing Address - Zip Code:80440-4000
Mailing Address - Country:US
Mailing Address - Phone:719-839-0839
Mailing Address - Fax:888-713-2009
Practice Address - Street 1:301 E MAIN ST # 220
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211-5011
Practice Address - Country:US
Practice Address - Phone:719-839-0839
Practice Address - Fax:888-713-2009
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2019-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO992864101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health