Provider Demographics
NPI:1780339416
Name:BEAULIEU, JANET CECELIA (MSW, LADC)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:CECELIA
Last Name:BEAULIEU
Suffix:
Gender:F
Credentials:MSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 E 24TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3959
Mailing Address - Country:US
Mailing Address - Phone:612-721-9830
Mailing Address - Fax:
Practice Address - Street 1:1315 E 24TH ST STE 1
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3959
Practice Address - Country:US
Practice Address - Phone:612-721-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)