Individual
MARTHA BEENKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW., LICSW.
Contact information
Practice address
4655 NICOLS RD, SUITE 206, EAGAN, MN 55122-2395
(612) 597-5986
(651) 405-0358
Mailing address
4655 NICOLS RD, SUITE 206, EAGAN, MN 55122-3425
(612) 597-5986
(651) 405-0358
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14040 LICSW
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HP66834
FAM.COUNSEL, MH, BEHAVIOR
MN
Enumeration date
10/31/2006
Last updated
07/09/2007
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