Individual provider Active NPI

Beth Marie Traveria, PSYD, LPCC

  • Professional Counselor
  • Massillon, OH
National Provider Identifier
1518973775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E2890 Issued in OH
Practice address
4051 Lincoln Way E
Massillon, OH 44646-3770
Phone
(330) 477-8770
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E2890 OH Primary

Addresses

Primary practice location

4051 Lincoln Way E
Massillon, OH 44646-3770

Mailing address

1457 Cottage PL NW
Canton, OH 44703-1005
Phone (330) 327-6485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240119000380 SC Practitioner - Mental Health Counselor 5991157596 Practice locations: Myrtle Beach, SC
I20250127000436 GA Practitioner - Mental Health Counselor 5991157596 Practice locations: Cumming, GA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Myrtle Beach, SC 29579
Phone (330) 327-6485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E2890OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kothari Medical Associates, Inc. PastSince Aug 3, 2014 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518973775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1457 COTTAGE PL NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447031005",
            "telephone_number": "330-327-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446463770",
            "telephone_number": "330-477-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVERIA",
        "first_name": "BETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PSYD, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E2890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.