Provider Demographics
NPI:1518499193
Name:BEAM, KIMBERLY JOY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:JOY
Last Name:BEAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 MAPLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1028
Mailing Address - Country:US
Mailing Address - Phone:484-886-6947
Mailing Address - Fax:
Practice Address - Street 1:114 FORREST AVE
Practice Address - Street 2:104
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2218
Practice Address - Country:US
Practice Address - Phone:484-450-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-01
Last Update Date:2017-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0192851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical