Elyse Delphine Johnson Beach, M.S., CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7151013455 Issued in MI

Practice address

14153 Rick Dr
Shelby Township, MI 48315-2951

Phone

(586) 566-0326

NPI assigned

Jun 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Thera-Peds

  • Physical Therapy Clinic/Center
  • Macomb, MI
  • NPI 1508202151
  NPD

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1780251983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6862 FOXTHORN RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872677",
            "telephone_number": "313-806-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14153 RICK DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483152951",
            "telephone_number": "586-566-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "ELYSE",
        "middle_name": "DELPHINE JOHNSON",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7151013455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN- DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "7151013455",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elyse@therapedsforkids.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Thera-Peds",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "14153 Rick Dr",
            "city": "Shelby Twp",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483152951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elyse@therapedsforkids.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Thera-Peds",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "14153 Rick Dr",
            "city": "Shelby Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483152951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Allen Baubie
• Gina Michelle Bausano
• Kristin Marie Baxter
• Tala Bayasi
• Stephanie Bazydlo, RD
• Cheyenne Beard
• Karen L Beasley, MD
• Theresa Marie Beauregard, ATC
• Alec R Beck
• Laura Michelle-Levy Bednarsh

• Speech-Language Pathologist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Speech-Language Pathologist in Michigan

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