Provider Demographics
NPI:1750395240
Name:BEUMER, MONICA A (PHD LP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:A
Last Name:BEUMER
Suffix:
Gender:F
Credentials:PHD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 OAK ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-3610
Mailing Address - Country:US
Mailing Address - Phone:320-202-1400
Mailing Address - Fax:
Practice Address - Street 1:451 E SAINT GERMAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-4649
Practice Address - Country:US
Practice Address - Phone:320-202-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1085591OtherARAZ
MN62G72BEOtherBCBS
MN115822OtherUCARE