Individual provider Active NPI

Kyla Beecham

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1417410978
Registry record updated Apr 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1802884 Issued in OH
Practice address
3100 E 45TH St Ste 314
Cleveland, OH 44127-1095
Phone
(216) 441-9622
Fax
(888) 460-4717
NPI assigned
Apr 11, 2019
Last updated
Apr 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1802884 OH Primary

Addresses

Primary practice location

3100 E 45TH St Ste 314
Cleveland, OH 44127-1095

Mailing address

3100 E 45TH St Ste 314
Cleveland, OH 44127-1095
Phone (216) 441-9622

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1802884OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Wellness Solutions LLC CurrentSince Feb 8, 2023 Accepting new patients

Locations

4770 Indianola Ave
Ste 107
Columbus, OH 43214
Phone (614) 371-2303

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": "1554940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1417410978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 314",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271095",
            "telephone_number": "216-441-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E 45TH ST STE 314",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441271095",
            "telephone_number": "216-441-9622",
            "fax_number": "888-460-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEECHAM",
        "first_name": "KYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-11",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1802884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; 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.