Active NPI
Bradley Jack Beatty, LICDC-CS
- Addiction (Substance Use Disorder) Counselor
- Grove City, OH
National Provider Identifier
1669872107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 910395
- Practice address
- 3767 Richard Ave
Grove City, OH 43123-2417 - Phone
- (614) 877-2441
- NPI assigned
- Sep 3, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 910395 | OH | Primary |
Addresses
Primary practice location
3767 Richard Ave
Grove City, OH 43123-2417
Mailing address
3767 Richard Ave
Grove City, OH 43123-2417
Phone (614) 877-2441
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 |
|---|---|---|---|
| 910395 | 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": "1409702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409702400000",
"number": "1669872107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3767 RICHARD AVE",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431232417",
"telephone_number": "614-877-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3767 RICHARD AVE",
"city": "GROVE CITY",
"state": "OH",
"postal_code": "431232417",
"telephone_number": "614-877-2441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEATTY",
"first_name": "BRADLEY",
"middle_name": "JACK",
"name_prefix": "Mr.",
"credential": "LICDC-CS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-03",
"last_updated": "2014-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "910395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grove City, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.