NPIMap

Organization Active NPI

Beachside Adult and Family Therapy Inc

  • Mental Health Counselor
  • Ventura, CA
National Provider Identifier
1992018469
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
BEACHSIDE ADULT AND FAMILY THERAPY INC
Practice address
3160 Telegraph Rd Ste 200
Ventura, CA 93003-3250
Phone
(805) 642-4611
Fax
(805) 585-3241
NPI assigned
Jul 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Authorized official

Name
Kerry O'Reilly, PSYD, LMFTNPI 1336355981
Title
Ceo
Phone
(310) 463-5656

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
PsychoanalystGroup: 193200000X MULTI-SPECIALTY GROUP 102L00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

3160 Telegraph Rd Ste 200
Ventura, CA 93003-3250

Mailing address

3160 Telegraph Rd Ste 200
Ventura, CA 93003-3250
Phone (805) 642-4611

Other identifiers 2

IdentifierTypeStateIssuer
1241840OtherBEACON
700687251MedicaidCA

Other names 1

  • Beachside Therapy and Assessment Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240322003143 CA Part B Supplier - Clinic/Group Practice 3870930035 Receives reassigned benefits from 15 practitioners
Practice locations: Ventura, CA

National Provider Directory

National Provider Directory

Locations

3160 Telegraph Rd
Ste 200
Ventura, CA 93003
Phone (805) 620-0346

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766707200000",
    "number": "1992018469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 TELEGRAPH RD STE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033250",
            "telephone_number": "805-642-4611",
            "fax_number": "805-585-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 TELEGRAPH RD STE 200",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033250",
            "telephone_number": "805-642-4611",
            "fax_number": "805-585-3241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE ADULT AND FAMILY THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A",
        "authorized_official_last_name": "O'REILLY",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-463-5656",
        "authorized_official_credential": "PSYD, LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychoanalyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "1241840",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700687251",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beachside Therapy and Assessment Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; 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.