Provider Demographics
NPI:1780146217
Name:BEEKS, YAZMIN (LGSW)
Entity type:Individual
Prefix:
First Name:YAZMIN
Middle Name:
Last Name:BEEKS
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3360 HUNTLEY SQUARE DR APT A1
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-6223
Mailing Address - Country:US
Mailing Address - Phone:908-414-5610
Mailing Address - Fax:
Practice Address - Street 1:9015 WOODYARD RD STE 109
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4226
Practice Address - Country:US
Practice Address - Phone:301-541-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD240661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical