Provider Demographics
NPI:1447812409
Name:BETH C. HEAN, LICSW LLC
Entity type:Organization
Organization Name:BETH C. HEAN, LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:HEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-829-1459
Mailing Address - Street 1:1 MASSACHUSETTS RD
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-1313
Mailing Address - Country:US
Mailing Address - Phone:401-829-1459
Mailing Address - Fax:
Practice Address - Street 1:36 N BEDFORD ST STE C22
Practice Address - Street 2:
Practice Address - City:EAST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02333-1186
Practice Address - Country:US
Practice Address - Phone:401-829-1459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-30
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty