Bethany Gavic
Clinical Social Worker
1900 Silver Lake Rd Nw Suite 110
New Brighton
, Minnesota 55112-1786
Bethany Gavic
Clinical Social Worker
1900 Silver Lake Rd Nw Suite 110
New Brighton
, Minnesota 55112-1786
(651) 628-0411
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About
Features
Specialties
- Clinical Social Worker
Languages spoken
- English
Location
First Address
- Bethany Gavic
- 1900 Silver Lake Rd Nw Suite 110
- New Brighton, MN
- Zip : 55112-1786
- Fax : (651) 628-0411
- Phone : (651) 628-9566
Second Address
- Bethany Gavic
- 1900 Silver Lake Rd Nw Suite 110
- New Brighton, MN
- Zip : 55112-1786
- Fax : (651) 628-0411
- Phone : (651) 628-9566
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1041C0700X | Clinical Social Worker | 20349 | MN |
National Provider Identifier
| NPI | 1003153792 |
|---|---|
| Provider Name | Bethany Gavic |
| First Address | New Brighton, MN 55112-1786 |
| Second Address | New Brighton, MN 55112-1786 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/01/2013 |
| Last Update Date | 15/01/2013 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.