Individual provider Active NPI

Velvet Denise Beckwith, LCAS

  • Addiction (Substance Use Disorder) Counselor
  • Raleigh, NC
National Provider Identifier
1215060637
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1071 Issued in NC
Practice address
721 Tucker St
Raleigh, NC 27603-1248
Phone
(919) 833-8862
Fax
(919) 833-8595
NPI assigned
Mar 14, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1071 NC Primary

Addresses

Primary practice location

721 Tucker St
Raleigh, NC 27603-1248

Mailing address

64 Ridgeway Drewry Rd
PO Box 286
Manson, NC 27553-9737
Phone (252) 456-4057

Other identifiers 1

IdentifierTypeStateIssuer
6111888MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1071NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Skills Counseling, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215060637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 RIDGEWAY DREWRY RD",
            "address_2": "PO BOX 286",
            "city": "MANSON",
            "state": "NC",
            "postal_code": "275539737",
            "telephone_number": "252-456-4057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 TUCKER ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276031248",
            "telephone_number": "919-833-8862",
            "fax_number": "919-833-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKWITH",
        "first_name": "VELVET",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6111888",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.