Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Wyatt Beam, LICSW

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1396406245

Jack Wyatt Beam, LICSW is a Student in an Organized Health Care Education/Training Program in Shoreline, Washington. Licensed in Washington. Registered with an NPI since 2022.

Licensed in
WA
In the registry since
2022
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

17018 15th Ave NE
Shoreline, WA 98155-5137
Phone: (206) 362-7282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence LW70069003 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396406245
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJanuary 3, 2022
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026

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