Individual provider Active NPI

Chris Beam, LPC

  • Professional Counselor
  • Bainbridge, GA
National Provider Identifier
1770608952
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004327 Issued in GA
Practice address
1605B E Shotwell St
Bainbridge, GA 39819-4347
Phone
(229) 243-1633
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004327 GA Primary

Addresses

Primary practice location

1605B E Shotwell St
Bainbridge, GA 39819-4347

Mailing address

1605B E Shotwell St
Bainbridge, GA 39819-4347
Phone (229) 243-1633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240309000214 GA Practitioner - Mental Health Counselor 6002173887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
May accept Medicare assignment
Group practices
Samaritan Counseling Center of Southwest Georgia, Inc.Group PAC ID 1557628336, 2 clinicians

Practice addresses (Care Compare)

208 S Broad St
Bainbridge, GA 39817-3616
Phone (229) 243-1633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC004327GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of Southwest Georgia, Inc. Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

1605 E Shotwell St
Ste B
Bainbridge, GA 39819
Phone (229) 243-1633

208 S Broad St
Bainbridge, GA 39817
Phone (229) 243-1633

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770608952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605B E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194347",
            "telephone_number": "229-243-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605B E SHOTWELL ST",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398194347",
            "telephone_number": "229-243-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAM",
        "first_name": "CHRIS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge, GA

Sources for this page

Verify at the official NPI Registry.