NPIMap

Organization Active NPI

Rewind Behavior and Simulation Center LLC

  • Professional Counselor
  • Monroeville, PA
National Provider Identifier
1346784907
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC008797 Issued in PA
Legal business name
REWIND BEHAVIOR AND SIMULATION CENTER LLC
Practice address
204 Kenmar Dr Ste 5
Monroeville, PA 15146-1705
Phone
(412) 245-7811
NPI assigned
Dec 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Authorized official

Name
Dr. Keshona T Beasley, PH.D, LPC, NCCNPI 1255782066
Title
Ceo
Phone
(412) 245-7811

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X PC008797 PA Primary

Addresses

Primary practice location

204 Kenmar Dr Ste 5
Monroeville, PA 15146-1705

Mailing address

204 Kenmar Dr Ste 5
Monroeville, PA 15146-1705

National Provider Directory

National Provider Directory

Locations

204 Kenmar Dr
Ste 5
Monroeville, PA 15146
Phone (412) 245-7811

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": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1346784907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 KENMAR DR STE 5",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 KENMAR DR STE 5",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461705",
            "telephone_number": "412-245-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REWIND BEHAVIOR AND SIMULATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "KESHONA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "412-245-7811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.