MEDICARE: COURTNEY BEAMER LICSW/LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	104211	CA
2	1041C0700X	Clinical Social Worker	089.0134504	VT

General Provider Information

NPI Number	:	1699429308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY BEAMER LICSW/LCSW

Provider Business Mailing Address
First Line	:	1246 OSGOOD HILL RD
Second Line	:
City	:	WESTFORD
State	:	VT
Zip	:	05494-9750
Country	:	US
Telephone Number	:	213-293-6192
Fax Number	:

Provider Business Practice Location Address
First Line	:	1246 OSGOOD HILL RD
Second Line	:
City	:	WESTFORD
State	:	VT
Zip	:	05494-9750
Country	:	US
Telephone Number	:	213-293-6192
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2022
Last Update Date	:	02/10/2022

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