Individual
BEAU JOHN ELKINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC, MBA
Contact information
Practice address
7590 LYRIC LN NE STE 114, FRIDLEY, MN 55432-3251
(763) 236-4373
(763) 236-4370
Mailing address
7590 LYRIC LN NE STE 114, FRIDLEY, MN 55432-3251
(763) 236-4508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
304158
MN
1041C0700X
Clinical Social Worker
Primary
22916
MN
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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