Provider Demographics
NPI:1356225148
Name:SCURICH, BEAU (LMSW)
Entity type:Individual
Prefix:
First Name:BEAU
Middle Name:
Last Name:SCURICH
Suffix:
Gender:X
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 BECKNER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-3691
Mailing Address - Country:US
Mailing Address - Phone:505-989-4500
Mailing Address - Fax:505-443-8313
Practice Address - Street 1:4801 BECKNER RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3641
Practice Address - Country:US
Practice Address - Phone:505-772-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker