NPIMap

Organization Active NPI

Beacon Community Services

  • Clinical Neuropsychologist
  • Southlake, TX
National Provider Identifier
1710759303
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
BEACON COMMUNITY SERVICES
Practice address
1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462
Phone
(817) 745-4526
NPI assigned
Oct 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Authorized official

Name
Dr. Andrea Lynn Rice, PH.D.NPI 1609105857
Title
Clinical Director
Phone
(817) 739-8013

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X

Addresses

Primary practice location

1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462

Mailing address

1560 E Southlake Blvd Ste 100
Southlake, TX 76092-6462
Phone (817) 745-4526

Other names 2

  • Beacon Community Services Former legal business name
  • Innovative Interventions, Inc. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698278400000",
    "number": "1710759303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926462",
            "telephone_number": "817-745-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926462",
            "telephone_number": "817-745-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "817-739-8013",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Community Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Innovative Interventions, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.