NPI 1003153792

Bethany Gavic, MSWLICSW

Practitioner Clinical Social Worker New Brighton, MN

Practice location

Address: 1900 Silver Lake Rd NW Suite 110, New Brighton, MN 55112-1786
Phone: (651) 628-9566
Fax: (651) 628-0411

Registered specialties

Clinical Social Worker Primary

Behavioral Health & Social Service Providers Taxonomy 1041C0700X Licence 20349 (MN)

Other Social Worker providers in Minnesota →

Registry record

NPI: 1003153792
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Jan 2013
Record last updated: 15 Jan 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.