Active NPI
Mary Beach, LCPC-C
- Mental Health Counselor
- South Portland, ME
National Provider Identifier
1013336254
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- XL3731
- Practice address
- 50 Lydia LN
South Portland, ME 04106-2156 - Phone
- (207) 874-1175
- NPI assigned
- Apr 15, 2014
- Last updated
- Apr 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | XL3731 | ME | Primary |
Addresses
Primary practice location
50 Lydia LN
South Portland, ME 04106-2156
Mailing address
50 Lydia LN
South Portland, ME 04106-2156
Phone (207) 874-1175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XL3731 | ME | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397520000000",
"number": "1013336254",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 LYDIA LN",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062156",
"telephone_number": "207-874-1175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 LYDIA LN",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062156",
"telephone_number": "207-874-1175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEACH",
"first_name": "MARY",
"name_prefix": "Mrs.",
"credential": "LCPC-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-15",
"last_updated": "2014-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "XL3731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.