Kelly Mae Beach, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

01076 Issued in NV

Practice address

3652 N Rancho Dr
Ste. 102
Las Vegas, NV 89130-3178

Phone

(702) 334-6162

Fax

(702) 515-0660

NPI assigned

May 1, 2007

Last updated

Mar 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Beach Therapy

  • Marriage & Family Therapist
  • Las Vegas, NV
  • NPI 1316244981
  Authorized official Same address or phone

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1215158746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 N. RANCHO DR.",
            "address_2": "STE. 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89130",
            "telephone_number": "702-334-6162",
            "fax_number": "702-515-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 N RANCHO DR",
            "address_2": "STE. 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303178",
            "telephone_number": "702-334-6162",
            "fax_number": "702-515-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "KELLY",
        "middle_name": "MAE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NV",
            "license": "01076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100512262",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Be Well Counseling and Services Center
• Be Well Counseling and Services Center
• Be Well Home Health Care LLC
• Beach Therapy
• Christine Beach
• Mark Beach
• Stephanie Beach
• Nadia Chene' Beacham, D.M.D.
• Makaila Beachem
• Beacon Academy of Nevada

• Marriage & Family Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Marriage & Family Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; 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.