Individual provider Active NPI

Grace Eva Beach, LMSW

  • Social Worker
  • Brewster, NY
National Provider Identifier
1184996753
Registry record updated Jan 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
084881-1 Issued in NY
Practice address
400 Doansburg Rd
Brewster, NY 10509-5902
Phone
(845) 279-2995
NPI assigned
Jan 30, 2012
Last updated
Jan 30, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 084881-1 NY Primary

Addresses

Primary practice location

400 Doansburg Rd
Brewster, NY 10509-5902

Mailing address

400 Doansburg Road
Brewster, NY 10509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151125001755 NY Practitioner - Clinical Social Worker 7517267420 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084881-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Putnam Family and Community Services Inc CurrentSince Sep 21, 2015 Accepting new patients
Putnam Family and Community Services Inc PastSince Sep 21, 2015 Accepting new patients

Locations

1808 Route 6
Carmel, NY 10512
Phone (845) 225-2700

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": "1327881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1184996753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DOANSBURG ROAD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 DOANSBURG RD",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "105095902",
            "telephone_number": "845-279-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "GRACE",
        "middle_name": "EVA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "084881-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

Verify at the official NPI Registry.