Beacon Psychiatry PLLC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

Legal business name

BEACON PSYCHIATRY PLLC

Practice address

5 Bristol Dr
Ste 3F
South Easton, MA 02375

Phone

(617) 575-9830

NPI assigned

Nov 5, 2024

Last updated

Nov 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tara Conklin, PMHNPNPI 1023741709

Title

Partner

Phone

(203) 858-1690

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Tara Conklin, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Boston, MA
  • NPI 1023741709
  Authorized official Same address or phone

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

{
    "created_epoch": "1730764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730764800000",
    "number": "1114740487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 LIBERTY SQ # 97524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021095800",
            "telephone_number": "617-575-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BRISTOL DR",
            "address_2": "STE 3F",
            "city": "SOUTH EASTON",
            "state": "MA",
            "postal_code": "02375",
            "telephone_number": "617-575-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-29",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "203-858-1690",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in South Easton, MA
• Providers in South Easton, MA by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.