Beacon Psychotherapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BEACON PSYCHOTHERAPY PLLC

Practice address

1135 Kildaire Farm Rd Ste 315
Cary, NC 27511-4587

Phone

(919) 794-5490

NPI assigned

Dec 7, 2021

Organization subpart

No

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

Authorized official

Name

Matthew Robert Kreiner, LCSWNPI 1740721224

Title

Owner

Phone

(614) 560-3322

Specialties & licenses 1

Addresses

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Kreiner, LCSW

  • Clinical Social Worker
  • Cary, NC
  • NPI 1740721224
  NPD Authorized official

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1649938507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 KILDAIRE FARM RD STE 315",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114587",
            "telephone_number": "919-794-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 KILDAIRE FARM RD STE 315",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275114587",
            "telephone_number": "919-794-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "KREINER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-560-3322",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1820 White Dogwood Rd",
            "city": "Apex",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275029017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.simplepractice.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "SimplePractice",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Password protected information",
            "address_1": "1135 Kildaire Farm Rd Ste 315",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275114587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• James M Bazluki, LAT, ATC
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• Sarah Elizabeth Beachum
• Beacon Specialized Living North Carolina
• Samuel Bret Beaman, PT, DPT
• Erin Hunter Beasley
• Grace Elizabeth Emily Beasley
• John M Beasley, BA

• Clinical Social Worker in Cary, NC
• Providers in Cary, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.