NPIMap

Organization Active NPI

Beacon Behavioral Hospital LLC

Doing business as Beacon Behavioral Outpatient - Lutcher

  • Mental Health Counselor
  • Lutcher, LA
National Provider Identifier
1386277283
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BEACON BEHAVIORAL HOSPITAL LLC
Doing business as
Beacon Behavioral Outpatient - Lutcher
Beacon Behavioral Outpatient - Telehealth
Practice address
2471 Louisiana Ave
Lutcher, LA 70071-5413
Phone
(225) 258-6112
Fax
(225) 258-6111
NPI assigned
Feb 19, 2020
Last updated
Jan 21, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
BEACON BEHAVIORAL HOSPITAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Mr. Phillip Sean Wendell
Title
Ceo
Phone
(225) 810-4040

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

2471 Louisiana Ave
Lutcher, LA 70071-5413

Mailing address

4601 Bluebonnet Blvd Ste B
Baton Rouge, LA 70809-9656
Phone (225) 810-4040

Other identifiers 2

IdentifierTypeStateIssuer
2184164MedicaidLA
194102OtherMEDICARE

Other names 2

  • Beacon Behavioral Outpatient - Lutcher Doing business as
  • Beacon Behavioral Outpatient - Telehealth Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beacon Behavioral Hospital LLC6 organizations share this tax ID, including this one
Part of
Beacon Behavioral Hospital LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1386277283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 BLUEBONNET BLVD STE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708099656",
            "telephone_number": "225-810-4040",
            "fax_number": "225-810-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 LOUISIANA AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715413",
            "telephone_number": "225-258-6112",
            "fax_number": "225-258-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BEACON BEHAVIORAL HOSPITAL LLC",
        "enumeration_date": "2020-02-19",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "WENDELL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-810-4040",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2184164",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "194102",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Behavioral Outpatient - Lutcher",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Behavioral Outpatient - Lutcher",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Behavioral Outpatient - Telehealth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lutcher, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.