NPIMap

Organization Active NPI

Beacon Behavioral Health Services

  • Community/Behavioral Health Agency
  • Fremont, OH
National Provider Identifier
1891374930
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BEACON BEHAVIORAL HEALTH SERVICES
Practice address
114 N Wood St
Fremont, OH 43420-2440
Phone
(567) 201-2048
Fax
(567) 280-4395
NPI assigned
Apr 6, 2021
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Mrs. Melissa Ann Tester, LICDC-CS, LSWNPI 1811191737
Title
Owner/Executive Director
Phone
(567) 201-2048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

114 N Wood St
Fremont, OH 43420-2440

Mailing address

114 N Wood St
Fremont, OH 43420-2440
Phone (567) 201-2048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211116002926 OH Part B Supplier - Clinic/Group Practice 4385033158 Receives reassigned benefits from 1 practitioner
Practice locations: Fremont, OH

National Provider Directory

National Provider Directory
Tax ID family
Beacon Behavioral Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1891374930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 N WOOD ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202440",
            "telephone_number": "567-201-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N WOOD ST",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434202440",
            "telephone_number": "567-201-2048",
            "fax_number": "567-280-4395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "TESTER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "567-201-2048",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICDC-CS, LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.