Provider Demographics
NPI:1821032053
Name:BECK, DEAN M (LICSW)
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:M
Last Name:BECK
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 SOUTH 2ND ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5729
Mailing Address - Country:US
Mailing Address - Phone:701-258-3780
Mailing Address - Fax:701-258-6431
Practice Address - Street 1:600 SOUTH 2ND ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5729
Practice Address - Country:US
Practice Address - Phone:701-258-3780
Practice Address - Fax:701-258-6431
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND23481041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00310979OtherRR MEDICARE
ND19133Medicaid
023459OtherBCBS OF ND PIN
HP65338OtherHEALTH PARTNERS
023459OtherBCBS OF ND PIN
P00310979OtherRR MEDICARE