Individual provider Active NPI

Marcia Ann Beasley

  • Mental Health Counselor
  • Wooster, OH
National Provider Identifier
1265176853
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C.2204049 Issued in OH
Practice address
2285 Benden Dr
Wooster, OH 44691-2568
Phone
(330) 264-9029
Fax
(330) 263-7251
NPI assigned
Apr 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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 C.2204049 OH Primary

Addresses

Primary practice location

2285 Benden Dr
Wooster, OH 44691-2568

Mailing address

2285 Benden Dr
Wooster, OH 44691-2568
Phone (330) 264-9029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260612001213 OH Practitioner - Mental Health Counselor 3274005095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13940 Cedar Rd
Suite 204
University HTS, OH 44118-3204

13940 Cedar Rd
Suite 204
University HTS, OH 44118-3206

21887 Lorain Rd
Suite 226
Fairview Park, OH 44126-3330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2204049OHMDMental Health Counselor

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": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1265176853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029",
            "fax_number": "330-263-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 BENDEN DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912568",
            "telephone_number": "330-264-9029",
            "fax_number": "330-263-7251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "MARCIA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2204049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.