Provider Demographics
NPI:1215306089
Name:BEYER, LAURIE JANE (MSW, LISW)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:JANE
Last Name:BEYER
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 WEST SUPERIOR STREET
Mailing Address - Street 2:SUITE #505
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-1725
Mailing Address - Country:US
Mailing Address - Phone:218-722-4880
Mailing Address - Fax:218-722-4662
Practice Address - Street 1:324 WEST SUPERIOR STREET
Practice Address - Street 2:SUITE #505
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1725
Practice Address - Country:US
Practice Address - Phone:218-722-4880
Practice Address - Fax:218-722-4662
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN136191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical