Active NPI
Eric J Beasley, CAADC
- Mental Health Counselor
- Snellville, GA
National Provider Identifier
1801153929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2330 Scenic Hwy S Ste 111
Snellville, GA 30078-3115 - Phone
- (404) 895-3199
- NPI assigned
- Apr 13, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1766 | GA | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2330 Scenic Hwy S Ste 111
Snellville, GA 30078-3115
Mailing address
2330 Scenic Hwy S Ste 111
Snellville, GA 30078-3115
Phone (404) 895-3199
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1766 | Other | GA | DEPARTMENT HUMAN RESOURCES |
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 |
|---|---|---|---|
| 1766 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1801153929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 SCENIC HWY S STE 111",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300783115",
"telephone_number": "404-895-3199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 SCENIC HWY S STE 111",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300783115",
"telephone_number": "404-895-3199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEASLEY",
"first_name": "ERIC",
"middle_name": "J",
"credential": "CAADC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-13",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "GA",
"license": "1766",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT HUMAN RESOURCES",
"identifier": "1766",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.