Healthcare Provider Details

I. General information

NPI: 1821032053
Provider Name (Legal Business Name): DEAN M BECK LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SOUTH 2ND ST SUITE 201
BISMARCK ND
58504-5729
US

IV. Provider business mailing address

600 SOUTH 2ND ST SUITE 201
BISMARCK ND
58504-5729
US

V. Phone/Fax

Practice location:
  • Phone: 701-258-3780
  • Fax: 701-258-6431
Mailing address:
  • Phone: 701-258-3780
  • Fax: 701-258-6431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2348
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2348
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: