Healthcare Provider Details

I. General information

NPI: 1821293259
Provider Name (Legal Business Name): PATRICIA L. SPIRK BEAUMONT MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2007
Last Update Date: 06/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 OLDE HICKORY RD SECOND FLOOR
LANCASTER PA
17601-4929
US

IV. Provider business mailing address

56 NORTHVIEW DR
LANCASTER PA
17601-3220
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-3768
  • Fax: 717-560-6537
Mailing address:
  • Phone: 717-560-9627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW013196
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: