NPIMap

Organization Active NPI

Beacon Youth & Prevention Services

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Salem, OR
National Provider Identifier
1497205686
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
BEACON YOUTH & PREVENTION SERVICES
Practice address
3000 Market St NE
Suite 528
Salem, OR 97301-1882
Phone
(971) 600-3864
NPI assigned
Oct 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Kelly Lynn ButlerNPI 1699953885
Title
Executive Director
Phone
(971) 600-3864

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
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

3000 Market St NE
Suite 528
Salem, OR 97301-1882

Mailing address

3000 Market St NE
Suite 528
Salem, OR 97301-1882

National Provider Directory

National Provider Directory

Locations

3000 Market St NE
Ste 528
Salem, OR 97301
Phone (971) 600-3864

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": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1497205686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE",
            "address_2": "SUITE 528",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MARKET ST NE",
            "address_2": "SUITE 528",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973011882",
            "telephone_number": "971-600-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON YOUTH & PREVENTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "971-600-3864"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

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