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General NPI Number Information
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NPI Number | 1780276774
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Entity Type | Individual
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Provider Name | GABRIELLE JENSEN BEAUJEU LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/10/2021
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 272 NW MEDICAL LOOP STE E
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City | ROSEBURG
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State | OR
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Zip | 97471-5545
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Country | US
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Telephone | 541-900-4285
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 431
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City | NESKOWIN
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State | OR
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Zip | 97149-0431
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Country | US
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Telephone | 971-340-3761
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L16478
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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