Active NPI
Shirley Beasley
- Addiction (Substance Use Disorder) Counselor
- Cleveland, OH
National Provider Identifier
1548755796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CDCA.169322
- Practice address
- 1744 Payne Ave
Cleveland, OH 44114-2910 - Phone
- (216) 623-6555
- NPI assigned
- Jun 28, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.169322 | OH | Primary |
Addresses
Primary practice location
1744 Payne Ave
Cleveland, OH 44114-2910
Mailing address
1744 Payne Ave
Cleveland, OH 44114-2910
Phone (216) 623-6555
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.169322 | OH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561593600000",
"number": "1548755796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1744 PAYNE AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441142910",
"telephone_number": "216-623-6555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1744 PAYNE AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441142910",
"telephone_number": "216-623-6555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEASLEY",
"first_name": "SHIRLEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-28",
"last_updated": "2019-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.169322",
"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 Jun 27, 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.