Individual provider Active NPI

Stephanie Beaman

  • Mental Health Counselor
  • Binghamton, NY
National Provider Identifier
1649649203
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
47 Broad Ave
Binghamton, NY 13904-1421
Phone
(607) 771-8888
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0000889 CO
Professional Counselor 101YP2500X LPC.0015274 CO
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

47 Broad Ave
Binghamton, NY 13904-1421

Mailing address

47 Broad Ave
Binghamton, NY 13904-1421
Phone (607) 771-8888

Other names 1

  • Stephanie Carlin Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
ACD.0000889COMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Association of the Southern Tier, Inc. CurrentSince Dec 29, 2024 Accepting new patients
Intrepid Therapeutic Services LLC Current Accepting new patients

Locations

300 E Horsetooth Rd
Ste 200
Fort Collins, CO 80525
Phone (405) 474-4833

47 Broad Ave
Binghamton, NY 13904
Phone (607) 765-7827

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1649649203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041421",
            "telephone_number": "607-771-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 BROAD AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139041421",
            "telephone_number": "607-771-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAMAN",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0000889",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0015274",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "CARLIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.