| Brenda Beard Lcsw Pllc | |
|
5702 Elaine Dr Ste 101 Rockford IL 61108-2458 | |
| (815) 973-0823 | |
| Not Available |
| Full Name | Brenda Beard Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 5702 Elaine Dr Ste 101, Rockford, Illinois |
| Authorized Official Name and Position | Brenda Beard (OWNER) |
| Authorized Official Contact | 8159730823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda Beard Lcsw Pllc 5702 Elaine Dr Ste 101 Rockford IL 61108-2458 Ph: (815) 973-0823 | Brenda Beard Lcsw Pllc 5702 Elaine Dr Ste 101 Rockford IL 61108-2458 Ph: (815) 973-0823 |
| NPI Number | 1598361750 |
|---|---|
| Provider Enumeration Date | 12/11/2020 |
| Last Update Date | 12/11/2020 |
| Certification Date | 12/11/2020 |
| Medicare PECOS PAC ID | 9032521893 |
|---|---|
| Medicare Enrollment ID | O20201219000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598361750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Brenda K Beard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235306283 PECOS PAC ID: 8325118367 Enrollment ID: I20080603000656 |
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