Provider Demographics
NPI:1699429308
Name:BEAMER, COURTNEY (LICSW/LCSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BEAMER
Suffix:
Gender:F
Credentials:LICSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 OSGOOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05494-9750
Mailing Address - Country:US
Mailing Address - Phone:213-293-6192
Mailing Address - Fax:
Practice Address - Street 1:1246 OSGOOD HILL RD
Practice Address - Street 2:
Practice Address - City:WESTFORD
Practice Address - State:VT
Practice Address - Zip Code:05494-9750
Practice Address - Country:US
Practice Address - Phone:213-293-6192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1042111041C0700X
VT089.01345041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical