Provider Demographics
NPI:1902270051
Name:REMARCKE, BETH (LMFT)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:REMARCKE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14041 BURNHAVEN DR
Mailing Address - Street 2:SUITE 145
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4921
Mailing Address - Country:US
Mailing Address - Phone:952-454-8158
Mailing Address - Fax:
Practice Address - Street 1:14041 BURNHAVEN DR
Practice Address - Street 2:SUITE 145
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4921
Practice Address - Country:US
Practice Address - Phone:952-454-8158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2679106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist