Abigail Beasley, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19425 Issued in MN

Practice address

4749 Chicago Ave Ste 2D
Minneapolis, MN 55407-4181

Phone

(503) 267-7292

NPI assigned

Jan 25, 2012

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children'S Home Society & Family Services

  • Community/Behavioral Health Agency
  • Brooklyn Park, MN
  • NPI 1447317029
  NPD (past)

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

{
    "created_epoch": "1327449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1316218118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 BOONE AVE N",
            "address_2": "SUITE 2",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554284563",
            "telephone_number": "763-515-2441",
            "fax_number": "763-515-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4749 CHICAGO AVE STE 2D",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554074181",
            "telephone_number": "503-267-7292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 Boone Ave N",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554284563",
            "country_code": "US",
            "telephone_number": "763-515-2441",
            "fax_number": "763-515-2442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "ABIGAIL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-25",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Lee Beamon
• Albertine S Beard, MD
• Jonathan Philip Beardsley, NP
• Diane L Bearman, PHD
• Beasley Counseling
• Ashley J Beasley, RN, CNP
• Shannon M Beasley, CPNP, PHN, CDE
• Arianna Beaton
• Ronni Kaye Beatty-Kollasch, ATC
• Zachary J Beatty, M.D.

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, 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 Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.