Roneiko Henderson Beasley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904008490 Issued in VA

Practice address

3500 Virginia Beach Blvd
Suite 210
Virginia Beach, VA 23452-4445

Phone

(757) 233-1900

Fax

(757) 233-1945

NPI assigned

Aug 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Self Actualization Counseling Services, LLC

  • Health Maintenance Organization
  • Virginia Beach, VA
  • NPI 1588086177
  NPD (past) Authorized official

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1861684011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 VIRGINIA BEACH BLVD",
            "address_2": "SUITE 210",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524445",
            "telephone_number": "757-233-1900",
            "fax_number": "757-233-1945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 VIRGINIA BEACH BLVD",
            "address_2": "SUITE 210",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234524445",
            "telephone_number": "757-233-1900",
            "fax_number": "757-233-1945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON BEASLEY",
        "first_name": "RONEIKO",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-13",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102091",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904008490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Hemmis, DPT
• Hemorrhoid Care Center of VA, P.C.
• Cornell Hemphill
• Kayla Nicole Hemphill, CPHT
• Jose Henao, MD
• Rochelle Henderson-Clark, PHD
• Ann Reid Henderson, M.S. CCC-SLP
• Edith Henderson, MD
• Janet L Henderson, MD
• Jocelyn C. Henderson

• Clinical Social Worker in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.