NPIMap

Organization Active NPI

Beach Brain PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leland, NC
National Provider Identifier
1104666031
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BEACH BRAIN PLLC
Doing business as
Beach Brain PLLC
Practice address
1108 New Pointe Blvd Ste 130 Pmb1080
Leland, NC 28451
Phone
(845) 648-9120
NPI assigned
May 29, 2024
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Yolanda L LedainNPI 1225354418
Title
Owner/Member
Phone
(845) 648-9120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1108 New Pointe Blvd Ste 130 Pmb1080
Leland, NC 28451

Mailing address

1108 New Pointe Blvd Ste 130 Pmb1080
Leland, NC 28451
Phone (845) 648-9120

Other names 1

  • Beach Brain PLLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beach Brain PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1104666031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 NEW POINTE BLVD STE 130 PMB1080",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "28451",
            "telephone_number": "845-648-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 NEW POINTE BLVD STE 130 PMB1080",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "28451",
            "telephone_number": "845-648-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH BRAIN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "LEDAIN",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "845-648-9120"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach Brain PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leland, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.