Individual provider Active NPI

Euvada Shernaye Beaton, MA, LAC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1073900924
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LAC 15152 Issued in AZ
Practice address
1921 S Alma School Rd
Suite 300
Mesa, AZ 85210-3036
Phone
(480) 755-5553
NPI assigned
Apr 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LAC 15152 AZ Primary

Addresses

Primary practice location

1921 S Alma School Rd
Suite 300
Mesa, AZ 85210-3036

Mailing address

1921 S Alma School Rd
Suite 300
Mesa, AZ 85210-3036
Phone (480) 755-5553

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LAC 15152AZMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1073900924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 S ALMA SCHOOL RD",
            "address_2": "SUITE 300",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103036",
            "telephone_number": "480-755-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 S ALMA SCHOOL RD",
            "address_2": "SUITE 300",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103036",
            "telephone_number": "480-755-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATON",
        "first_name": "EUVADA",
        "middle_name": "SHERNAYE",
        "credential": "MA, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LAC 15152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.

Verify at the official NPI Registry.