Provider Demographics
NPI:1255754263
Name:BEUCK, JULES E (LCSW)
Entity type:Individual
Prefix:MR
First Name:JULES
Middle Name:E
Last Name:BEUCK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3288 LITTLE MOUNTAIN DR APT A
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-0912
Mailing Address - Country:US
Mailing Address - Phone:909-520-2044
Mailing Address - Fax:
Practice Address - Street 1:3288 LITTLE MOUNTAIN DR APT A
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-0912
Practice Address - Country:US
Practice Address - Phone:909-520-2044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical