Provider Demographics
NPI:1881621480
Name:BEUS, REBECCA M (LSCSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:BEUS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 E KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1607
Mailing Address - Country:US
Mailing Address - Phone:888-878-6881
Mailing Address - Fax:785-826-1600
Practice Address - Street 1:1655 AVENUE K
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:KS
Practice Address - Zip Code:67439-4288
Practice Address - Country:US
Practice Address - Phone:785-472-4453
Practice Address - Fax:785-472-5352
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 6235104100000X
KS46791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS845537OtherBLUE CROSS BLUE SHIELD