Individual
MS. KIMBERLY L. BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1377-132
WI
1041C0700X
Clinical Social Worker
Primary
3671-123
WI
1041C0700X
Clinical Social Worker
3671-123 AND 1377
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12020
DEAN HEALTH PLAN
WI
01
—
391627035010
BLUE CROSS/BLUE SHIELD
WI
05
—
39241700
—
WI
01
—
999003778
WPS
WI
Enumeration date
04/21/2006
Last updated
01/19/2011
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