Byllie Jean Gwyn Beck, LICSW
Individual provider Active NPI Clinical Social Worker · White Earth, MN
NPI 1699369686 · NPPES record last updated Feb 22, 2021
Key facts
- NPI
- 1699369686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 20631 (MN)
- Practice address
- 24246 Crane Road
White Earth, MN 56591 - Phone
- (218) 983-4703
- NPI assigned
- Feb 22, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20631 | MN | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 20631 | MN | Yes |
Addresses
Primary practice location
24246 Crane Road
White Earth, MN 56591
Mailing address
3205 County Road 144
Waubun, MN 56589-9008
Phone (218) 556-6919
Other providers in White Earth, MN
- Beverly Gay Anderson
- Grant Justin Atwood
- Angela Marie Bellanger
- Katy Jo Braaten
- Kandi Burr-Fisher
- Tina Ann Heisler
- Willy Ann Heisler
All providers in White Earth, MN · Clinical Social Worker in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.