NPIMap

Organization Active NPI

Beacon Psychological Services

  • Psychologist
  • Livonia, MI
National Provider Identifier
1255990685
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
BEACON PSYCHOLOGICAL SERVICES
Practice address
33150 Schoolcraft Rd Ste L03
Livonia, MI 48150-1631
Phone
(248) 497-3411
NPI assigned
Jun 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Authorized official

Name
Kathryn StaronNPI 1972689792
Title
Limited Licensed Psychologist
Phone
(248) 497-3411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

33150 Schoolcraft Rd Ste L03
Livonia, MI 48150-1631

Mailing address

195 Shinnecock Dr
Brighton, MI 48114-8832

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1255990685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 SHINNECOCK DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481148832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33150 SCHOOLCRAFT RD STE L03",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501631",
            "telephone_number": "248-497-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "STARON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "LIMITED LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "248-497-3411"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.