Julie Van Beusekom, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19876 Issued in MN

Practice address

1772 Stieger Lake LN Ste 220
Victoria, MN 55386-7720

Phone

(952) 443-4600

Fax

(952) 443-4604

NPI assigned

Oct 17, 2023

Last updated

Oct 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1104608868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 STIEGER LAKE LN STE 220",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867720",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 STIEGER LAKE LN STE 220",
            "city": "VICTORIA",
            "state": "MN",
            "postal_code": "553867720",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BEUSEKOM",
        "first_name": "JULIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Victoria, MN
• Providers in Victoria, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.