Active NPI
Charles Lyman Beard III, LPC
- Professional Counselor
- Goodyear, AZ
National Provider Identifier
1922659739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-18256
- Practice address
- 2403 N Pebble Creek Pkwy
Goodyear, AZ 85395-9042 - Phone
- (480) 269-2139
- NPI assigned
- Sep 23, 2019
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-18256 | AZ | Primary |
Addresses
Primary practice location
2403 N Pebble Creek Pkwy
Goodyear, AZ 85395-9042
Mailing address
3450 N 3Rd St
Phoenix, AZ 85012-2331
Phone (602) 265-8338
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 |
|---|---|---|---|
| LPC-18256 | AZ | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Behavioral Health | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Mental Illness Community Based Residential Treatment Facility
- Phoenix, AZ
- NPI 1023023603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569196800000",
"number": "1922659739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 N 3RD ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850122331",
"telephone_number": "602-265-8338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2403 N PEBBLE CREEK PKWY",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853959042",
"telephone_number": "480-269-2139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEARD",
"first_name": "CHARLES",
"middle_name": "LYMAN",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-23",
"last_updated": "2019-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-18256",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.