Miriam Beauchamp
Individual provider Active NPI Mental Health Counselor · Passaic, NJ
NPI 1780417014 · NPPES record last updated Aug 22, 2024
Key facts
- NPI
- 1780417014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 37AC006670400 (NJ)
- Practice address
- 111 Lexington Ave
Passaic, NJ 07055-5297 - Phone
- (973) 471-8006
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC006670400 | NJ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Clinic of Passaic Inc | Current |
Accepting new patients |
Locations
111 Lexington Ave
Passaic, NJ 07055
Phone (973) 471-8006
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/mhcp/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC006670400 | NJ | Yes |
Addresses
Primary practice location
111 Lexington Ave
Passaic, NJ 07055-5297
Mailing address
111 Lexington Ave
Passaic, NJ 07055-5297
Phone (973) 471-8006
Other providers in Passaic, NJ
- Ghassan G. Bassil
- Aharon Bauman
- Rebecca Baumrind
- Bay Radiation Oncology,P.L.L.C
- Beacon at Sea Couneling LLC
- Michael Becht
- Behavioral Psychological Services, PC
- Bella Vista Pharmacy Inc
- Beneficial Medical Supply
- Shayna Berkowitz
All providers in Passaic, NJ · Mental Health Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.