Provider Demographics
NPI:1912430364
Name:BEAMER, JENNIFER ROSE (LSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ROSE
Last Name:BEAMER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 REEDER RD
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-8533
Mailing Address - Country:US
Mailing Address - Phone:570-220-5046
Mailing Address - Fax:
Practice Address - Street 1:759 SUSQUEHANNA TRL
Practice Address - Street 2:
Practice Address - City:WATSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17777-8109
Practice Address - Country:US
Practice Address - Phone:570-538-1240
Practice Address - Fax:570-538-1257
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132175104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker