Individual provider Active NPI

Michelle Beasley

  • Mental Health Counselor
  • Oakland, CA
National Provider Identifier
1215474796
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13290 Issued in CA
Practice address
2115 High St
Oakland, CA 94601-4335
Phone
(510) 393-8559
NPI assigned
Jan 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13290 CA Primary

Addresses

Primary practice location

2115 High St
Oakland, CA 94601-4335

Mailing address

2115 High St
Oakland, CA 94601-4335
Phone (510) 393-8559

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Community Counseling Services, Inc Past Accepting new patients
Through the Looking Glass PastSince Dec 1, 2023 Accepting new patients
The Alliance for Community Wellness PastSince Mar 12, 2023 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1215474796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 HIGH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946014335",
            "telephone_number": "510-393-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 HIGH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946014335",
            "telephone_number": "510-393-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-23",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "13290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.