Brian Beckham, LCADC

Key facts

NPI

1154049435

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

License

171338 (KY)

Practice address

501 Baxter Ave
Louisville, KY 40204-1103

Phone

(502) 233-3290

Fax

(502) 470-5915

NPI assigned

Aug 22, 2022

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2022.

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1154049435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041103",
            "telephone_number": "502-233-3290",
            "fax_number": "502-470-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402041103",
            "telephone_number": "502-233-3290",
            "fax_number": "502-470-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKHAM",
        "first_name": "BRIAN",
        "credential": "LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-22",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "171338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

• Mary B Becker, APRN
• Michael D. Becker, MD
• Michael Damian Becker, D.M.D
• Ashley Marie Beckett, MSN, CRNP, CPNP-AC
• Alyssa Beckham, RBT
• Christina B Beckham, DMD
• Elizabeth Beckham
• Nicholas Andrew Beckham
• Madison Elizabeth Beckley, MSN, APRN, FNP-C
• Emily Kathleen Beckman, APRN

All providers in Louisville, KY · Addiction (Substance Use Disorder) Counselor in Kentucky