Active NPI
Timothy Ryan Beard
- Addiction (Substance Use Disorder) Counselor
- Sacramento, CA
National Provider Identifier
1841948072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CI41470124
- Practice address
- 500 22ND St
Sacramento, CA 95816-3503 - Phone
- (916) 956-5711
- NPI assigned
- Mar 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CI41470124 | CA | Primary |
Addresses
Primary practice location
500 22ND St
Sacramento, CA 95816-3503
Mailing address
500 22ND St
Sacramento, CA 95816-3503
Phone (916) 956-5711
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 |
|---|---|---|---|
| CI41470124 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706659200000",
"number": "1841948072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 22ND ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958163503",
"telephone_number": "916-956-5711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 22ND ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958163503",
"telephone_number": "916-956-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "TIMOTHY",
"middle_name": "RYAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-16",
"last_updated": "2024-01-31",
"certification_date": "2024-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CI41470124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.