Individual
JONATHAN HOWARD BEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
6120 STADIUM DR STE 100, KALAMAZOO, MI 49009-3022
(800) 379-1600
Mailing address
59087 PINE GROVE RD, COLON, MI 49040-9747
(269) 317-8229
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801085483
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801085483
SOCIAL WORK LICENSE
MI
Enumeration date
12/03/2018
Last updated
12/03/2018
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