Active NPI
Mykeila Danae Beachy, LSW
- Clinical Social Worker
- Wooster, OH
National Provider Identifier
1053703108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S.1450666
- Practice address
- 3011 Akron Rd
Wooster, OH 44691-7904 - Phone
- (330) 749-4679
- NPI assigned
- Feb 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S.1450666 | OH | Primary |
Addresses
Primary practice location
3011 Akron Rd
Wooster, OH 44691-7904
Mailing address
PO Box 62
Apple Creek, OH 44606-0062
Phone (330) 749-4679
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 |
|---|---|---|---|
| S.1450666 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1424908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424908800000",
"number": "1053703108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 62",
"city": "APPLE CREEK",
"state": "OH",
"postal_code": "446060062",
"telephone_number": "330-749-4679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3011 AKRON RD",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446917904",
"telephone_number": "330-749-4679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEACHY",
"first_name": "MYKEILA",
"middle_name": "DANAE",
"name_prefix": "Mrs.",
"credential": "LSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-26",
"last_updated": "2015-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "S.1450666",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.