Individual provider Active NPI

Charles Ray Beckelhimer Jr., MSW

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1487299665
Registry record updated Oct 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1600 W Eau Gallie Blvd
Melbourne, FL 32935-4106
Phone
(304) 578-4554
NPI assigned
Nov 12, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW13200 FL
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1600 W Eau Gallie Blvd
Melbourne, FL 32935-4106

Mailing address

1600 W Eau Gallie Blvd Ste 201J
Melbourne, FL 32935-4149
Phone (304) 578-4554

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

LicenseStateTypeSpecialty
ISW13200FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1573516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1487299665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD STE 201J",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354149",
            "telephone_number": "304-578-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W EAU GALLIE BLVD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329354106",
            "telephone_number": "304-578-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKELHIMER",
        "first_name": "CHARLES",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-12",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW13200",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.