Provider Demographics
NPI:1326087107
Name:HEMMING, BETH M (LICSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:M
Last Name:HEMMING
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:MAVONNE
Other - Last Name:LOFSTRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:151 S 4TH ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4715
Mailing Address - Country:US
Mailing Address - Phone:701-795-3000
Mailing Address - Fax:701-795-3050
Practice Address - Street 1:151 S 4TH ST
Practice Address - Street 2:SUITE 401
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4715
Practice Address - Country:US
Practice Address - Phone:701-795-3000
Practice Address - Fax:701-795-3050
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND20411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND054519Medicaid
MN50B56HEOtherBCBSMN PROVIDER NUMBER
ND014194OtherBCBS ND PROVIDER NUMBER
NDN14194Medicare PIN
NDS23681Medicare UPIN