Active NPI
Kylee Beckett, RA,CDCA
- Addiction (Substance Use Disorder) Counselor
- Shadyside, OH
National Provider Identifier
1326671785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 171783
- Practice address
- 4645 Lincoln Ave
Shadyside, OH 43947-1242 - Phone
- (361) 720-2666
- NPI assigned
- Feb 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | 161912 | OH | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 171783 | OH | Primary |
Addresses
Primary practice location
4645 Lincoln Ave
Shadyside, OH 43947-1242
Mailing address
4645 Lincoln Ave
Shadyside, OH 43947-1242
Phone (361) 720-2666
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171783 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| 161912 | OH | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581552000000",
"number": "1326671785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4645 LINCOLN AVE",
"city": "SHADYSIDE",
"state": "OH",
"postal_code": "439471242",
"telephone_number": "361-720-2666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4645 LINCOLN AVE",
"city": "SHADYSIDE",
"state": "OH",
"postal_code": "439471242",
"telephone_number": "361-720-2666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKETT",
"first_name": "KYLEE",
"credential": "RA,CDCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-13",
"last_updated": "2020-02-13",
"certification_date": "2020-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "OH",
"license": "161912",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "171783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shadyside, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.