Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Timothy Ray Beverly, CDCA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1194211409

Mr. Timothy Ray Beverly, CDCA is an Addiction (Substance Use Disorder) Counselor in Fairborn, Ohio. Licensed in Ohio. Registered with an NPI since 2018.

Licensed in
OH
In the registry since
2018
Specialties on file
2

Practice location Address checks out

302 W Main St
Fairborn, OH 45324-5037
Phone: (937) 281-4673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence LCDCII.161829 (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 070488 (OH)

Record details

NPI number1194211409
Entity typeIndividual (Type 1)
GenderMale
Credentials CDCA
Sole proprietorNo
NPI enumeratedJuly 10, 2018
Last updated in NPPESJanuary 25, 2024
Certification dateJanuary 25, 2024
Mailing address100 Crowne Point Place, Cincinnati, OH 45241-5427

Other providers in Fairborn