Individual provider Active NPI

Christina Marie Beesley, MA

  • Counselor
  • Southbridge, MA
National Provider Identifier
1174646855
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
042-103-577 Issued in MA
Practice address
29 Pine St
Southbridge, MA 01550-1823
Phone
(508) 765-9167
NPI assigned
Apr 9, 2007
Last updated
May 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 042-103-577 MA Primary

Addresses

Primary practice location

29 Pine St
Southbridge, MA 01550-1823

Mailing address

29 Pine St
Southbridge, MA 01550-1823
Phone (508) 765-9167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109002531 MA Practitioner - Mental Health Counselor 2062803083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
042-103-577MAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Current Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

29 Pine St
Southbridge, MA 01550
Phone (508) 765-2202

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398988800000",
    "number": "1174646855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015501823",
            "telephone_number": "508-765-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 PINE ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015501823",
            "telephone_number": "508-765-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEESLEY",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2014-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MA",
            "license": "042-103-577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.