Active NPI
Brent Beam, PH.D.
- Counseling Psychologist
- Ann Arbor, MI
National Provider Identifier
1174710644
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301014665
- Practice address
- 218 N 4TH Ave
Suite 211
Ann Arbor, MI 48104-1472 - Phone
- (734) 531-8831
- NPI assigned
- Sep 28, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301014665 | MI | Primary |
Addresses
Primary practice location
218 N 4TH Ave
Suite 211
Ann Arbor, MI 48104-1472
Mailing address
617 W Liberty St
Apt 2
Ann Arbor, MI 48103-4384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 2, 2023 through Oct 2, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014665 | MI | MD | Counseling Psychologist |
| 4337 | NC | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332806400000",
"number": "1174710644",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "617 W LIBERTY ST",
"address_2": "APT 2",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481034384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 N 4TH AVE",
"address_2": "SUITE 211",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481041472",
"telephone_number": "734-531-8831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAM",
"first_name": "BRENT",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-28",
"last_updated": "2012-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301014665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.