Robert Malvin Beadle, LSW
Individual provider Active NPI Social Worker · Lisbon, OH
NPI 1982265724 · NPPES record last updated Mar 7, 2025
Key facts
- NPI
- 1982265724
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S.0700299 (OH)
- Practice address
- 966 N Market St
Lisbon, OH 44432-9363 - Phone
- (330) 424-1468
- NPI assigned
- Jun 24, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.0700299 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Recovery Center | Past | Accepting new patients | |
| National Youth Advocate Program, Inc | Past | Accepting new patients | |
| National Youth Advocate Program, Inc | Past |
Accepting new patients | |
| Family Recovery Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0700299 | OH | Yes |
Addresses
Primary practice location
966 N Market St
Lisbon, OH 44432-9363
Mailing address
464 Greenmont Dr
Canfield, OH 44406-9658
Phone (330) 559-3866
Other providers in Lisbon, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.