Cody L Beaton, LSCSW, LCAC – Clinical Social Worker

Key facts

NPI: 1235518291
Entity type: Individual (NPI type 1)
Primary specialty: Clinical Social Worker 1041C0700X
License: 4808 (KS)
Practice address: 9333 E 21St St N
Wichita, KS 67206-2927
Phone: (316) 634-4700
Fax: (316) 634-4770
NPI assigned: May 23, 2015
Sex: Male
Sole proprietor: No

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 and National Provider Directory roles.

Prairie View, Inc. Psychiatric Hospital · Wichita, KS · NPI 1902251655

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
658	KS	MD	Psychologist
4808	KS	MD	Clinical Social Worker

Practice roles

Organization	Specialty	Status	New patients
Prairie View, Inc.		Past since Nov 13, 2019	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X	658	KS
Clinical Social Worker	1041C0700X	4808	KS	Yes

Addresses

Primary practice location

9333 E 21St St N
Wichita, KS 67206-2927

Mailing address

1901 E 1St St; PO Box 467
Newton, KS 67114-0467
Phone (316) 284-6400

Other providers in Wichita, KS

All providers in Wichita, KS · Clinical Social Worker in Kansas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.