Beacon Psychiatry, LLC
Organization Active NPI Psychiatry Physician · Trinity, FL
NPI 1578140257 · NPPES record last updated Mar 27, 2021
Key facts
- NPI
- 1578140257
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- BEACON PSYCHIATRY, LLC
- Practice address
- 3610 Galileo Dr Ste 101
Trinity, FL 34655-1794 - Phone
- (727) 456-9135
- NPI assigned
- Mar 27, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Linh Phuong Thi Dinh, MD
- Title
- Owner/Medical Director
- Phone
- (727) 793-5558
Practitioners 8
-
Linh Phuong Thi Dinh, M.D.
-
Thirslon Williams, LMHC
-
Alyssa Siegworth, PA-C
-
Nicole Ashburn, PA-C
-
Bernice Baldwin, LMHC
-
Michelle Pastor, LMHC, CAP, ICADC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210702000134 | FL | Part B Supplier - Clinic/Group Practice | 8022419647 |
Receives reassigned benefits from 5 practitioners Practice locations: Trinity, FL |
National Provider Directory
Locations
3610 Galileo Dr
Ste 101
Trinity, FL 34655
Phone (727) 910-2395
8141 Bellarus Way
Ste 103
Trinity, FL 34655
Phone (727) 910-2395
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Clinical Social Worker |
1041C0700X | |||
| Marriage & Family Therapist |
106H00000X | |||
| Psychiatry Physician |
2084P0800X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
3610 Galileo Dr Ste 101
Trinity, FL 34655-1794
Mailing address
3610 Galileo Dr Ste 101
Trinity, FL 34655-1794
Phone (727) 456-9135
Other names
- Beacon Psychiatry
- Beacon Psychiatry, LLC
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | AdvancedMD | Health Information Exchange (HIE) |
Other providers in Trinity, FL
- Baycare Behavioral Health, Inc
- Baycare Medical Group Inc
- Baycare Medical Group Inc
- Baycare Medical Group Inc
- Baycare Medical Group Inc
- Kristin Avanell Beck
- Chad Beckstrom
- Behavior Analysis Consultants
- Brooke R Bellman
- Anaidiel Beltran
All providers in Trinity, FL · Psychiatry Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.