Provider Demographics
NPI:1114617859
Name:BEAUCLAIRE, HANNAH RUTH (MSW, LGSW)
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:RUTH
Last Name:BEAUCLAIRE
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:MRS
Other - First Name:HANNAH
Other - Middle Name:RUTH
Other - Last Name:BEAUCLAIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LGSW
Mailing Address - Street 1:5145 FARNHAM DR N
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-9150
Mailing Address - Country:US
Mailing Address - Phone:651-285-6455
Mailing Address - Fax:
Practice Address - Street 1:4637 PROVENCE WAY N
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:MN
Practice Address - Zip Code:55038-6055
Practice Address - Country:US
Practice Address - Phone:651-285-6455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-08
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN32803104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker