Active NPI
Octavia Beyah
- Mental Health Counselor
- Philadelphia, PA
National Provider Identifier
1881364180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4865 Market St
Philadelphia, PA 19139-3508 - Phone
- (610) 532-7810
- NPI assigned
- Sep 17, 2021
- Last updated
- Sep 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4865 Market St
Philadelphia, PA 19139-3508
Mailing address
200 N 16TH St Apt 1822
Philadelphia, PA 19102-1211
Phone (215) 300-1766
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | obeyah@cgrc.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- octavia.beyah@489656322949124.direct.elationemr.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631836800000",
"number": "1881364180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N 16TH ST APT 1822",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191021211",
"telephone_number": "215-300-1766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4865 MARKET ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191393508",
"telephone_number": "610-532-7810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEYAH",
"first_name": "OCTAVIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-17",
"last_updated": "2021-09-17",
"certification_date": "2021-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "obeyah@cgrc.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "4865 Market St",
"city": "Philadelphia",
"state": "PA",
"country_code": "US",
"postal_code": "191393508",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.