NPIMap

Organization Active NPI

Beach Therapy

  • Marriage & Family Therapist
  • Las Vegas, NV
National Provider Identifier
1316244981
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
01076 Issued in NV
Legal business name
BEACH THERAPY
Practice address
3652 N Rancho Dr
Suite 102
Las Vegas, NV 89130-3178
Phone
(702) 334-6162
Fax
(702) 515-0660
NPI assigned
Feb 17, 2011
Last updated
Jan 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Authorized official

Name
Kelly Beach, LMFTNPI 1215158746
Title
Owner
Phone
(702) 334-6162

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 01076 NV Primary

Addresses

Primary practice location

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

Mailing address

3652 N Rancho Dr
Suite 102
Las Vegas, NV 89130-3178
Phone (702) 334-6162

Other identifiers 1

IdentifierTypeStateIssuer
100512262MedicaidNV

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1316244981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 N RANCHO DR",
            "address_2": "SUITE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303178",
            "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": "SUITE 102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303178",
            "telephone_number": "702-334-6162",
            "fax_number": "702-515-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-17",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "BEACH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-334-6162",
        "authorized_official_credential": "LMFT"
    },
    "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": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.