Organization Active NPI

Beyond Vision Mental Health Inc

  • Psychiatry Physician
  • Chesterfield, MO
National Provider Identifier
1104440072
Registry record updated Aug 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
BEYOND VISION MENTAL HEALTH INC
Practice address
140 Long Rd Ste 123
Chesterfield, MO 63005-1282
Phone
(818) 308-4388
Fax
(855) 954-4533
NPI assigned
Jun 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2021

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

Authorized official

Name
Mr. D. Mark Fassett II
Title
Coo
Phone
(917) 822-9002

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Behavior TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 106S00000X
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X
Addiction Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0401X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

140 Long Rd Ste 123
Chesterfield, MO 63005-1282

Mailing address

331 N New Ballas Rd
Saint Louis, MO 63141-5502
Phone (818) 308-4388

Other names 1

  • Beyond Vision Inc Doing business as

National Provider Directory

National Provider Directory

Locations

140 Long Rd
Ste 123
Chesterfield, MO 63005
Phone (917) 822-9002

331 N New Ballas Rd
Unit 410215
Saint Louis, MO 63141

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1104440072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 N NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415502",
            "telephone_number": "818-308-4388",
            "fax_number": "855-954-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LONG RD STE 123",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051282",
            "telephone_number": "818-308-4388",
            "fax_number": "855-954-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYOND VISION MENTAL HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-05",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A",
        "authorized_official_last_name": "FASSETT",
        "authorized_official_first_name": "D. MARK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "917-822-9002",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beyond Vision Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beyond Vision Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.