Organization Active NPI

Beauty for Ashes, LLC

  • Clinical Social Worker
  • Edmond, OK
National Provider Identifier
1134510795
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4889 Issued in OK
Legal business name
BEAUTY FOR ASHES, LLC
Practice address
849 E 33Rd St
Edmond, OK 73013-5407
Phone
(405) 888-5299
Fax
(405) 888-5322
NPI assigned
Feb 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Authorized official

Name
Portia Goldsmith-Nickelberry, LCSWNPI 1730490079
Title
Owner/Operator
Phone
(405) 367-9034

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 4889 OK Primary

Addresses

Primary practice location

849 E 33Rd St
Edmond, OK 73013-5407

Mailing address

849 E 33Rd St
Edmond, OK 73013-5407
Phone (405) 888-5299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160510000553 OK Part B Supplier - Clinic/Group Practice 3971892282 Receives reassigned benefits from 1 practitioner
Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory

Locations

849 E 33rd St
Edmond, OK 73013
Phone (405) 697-1073

906 NW 92nd St
Oklahoma City, OK 73114
Phone (405) 303-1372

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1134510795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 E 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135407",
            "telephone_number": "405-888-5299",
            "fax_number": "405-888-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "849 E 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135407",
            "telephone_number": "405-888-5299",
            "fax_number": "405-888-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUTY FOR ASHES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-17",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH-NICKELBERRY",
        "authorized_official_first_name": "PORTIA",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "405-367-9034",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "4889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.