Shannon Lee Beauchamp, CADCII, ICADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

A021560216 Issued in CA

Practice address

3101 W Coast Hwy
Ste. 200
Newport Beach, CA 92663-4001

Phone

(619) 715-9408

NPI assigned

Oct 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1902357189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 VIA LIDO",
            "address_2": "STE. 241",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633908",
            "telephone_number": "619-715-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 W COAST HWY",
            "address_2": "STE. 200",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634001",
            "telephone_number": "619-715-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUCHAMP",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "credential": "CADCII, ICADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "A021560216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1790133346",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beaches Recovery LLC
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• Steven Robert Beanes, M.D.
• Holly Beardsley, PA-C
• Andrea Beatty, FNP-C
• Melissa Lynn Beaufoy, FNP
• Beautiful Smiles, Inc
• Luis Antonio Becerra, PSYD
• Lisa Carey Grossman Becht, M.D.
• Tiffany Lee Beck, MD

• Addiction (Substance Use Disorder) Counselor in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.