THE BEACON GROUP SW NPI 1104932250

NPI Information

NPI: 1104932250
Provider Name: THE BEACON GROUP SW

Doing Business As: BEACON GROUP SW INC

Classification: Psychologist - 103TM1800X
Entity Type: Organization

Specialization: Intellectual and Developmental Disabilities

Address:
308 W GLENN
TUCSON, AZ
ZIP 85705
Phone: (520) 622-4874
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THE BEACON GROUP SW is an intellectual and developmental disabilities in Tucson, AZ. THE BEACON GROUP SW NPI is 1104932250. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Beacon Group Sw Inc.

The provider's business location address is:

308 W GLENN
TUCSON, AZ
ZIP 85705
Phone: (520) 622-4874
Fax: (520) 620-6620

The provider's authorized official is Michelle Kroeger .
The authorized official title is Comptroller and has the following contact phone number (520) 622-4874.

The enumeration date for this NPI number is 8/22/2006 and was last updated on 1/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TR0400X	Psychologist	Rehabilitation			No
2	103TM1800X	Psychologist	Intellectual and Developmental Disabilities			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	634495	OTHER	ARIZONA	ARIZONA DEPARTMENT OF DEVELOPEMENTAL DISABILITIES
2	113035	OTHER	ARIZONA	PIMA HEALTH SYSTEM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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