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BEACON PSYCHOTHERAPY SERVICES LLC NPI 1972016376


NPI Information

NPI: 1972016376
Provider Name: BEACON PSYCHOTHERAPY SERVICES, LLC
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
3640 S PLAZA TRL STE 103D
VIRGINIA BEACH, VA
ZIP 23452
Phone: (757) 818-4542
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BEACON PSYCHOTHERAPY SERVICES, LLC is a clinical social worker in Virginia Beach, VA. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. BEACON PSYCHOTHERAPY SERVICES, LLC NPI is 1972016376. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3640 S PLAZA TRL STE 103D
VIRGINIA BEACH, VA
ZIP 23452-363
Phone: (757) 818-4542
Fax: (757) 299-3031

The provider's authorized official is Fredric Harvey Bricka .
The authorized official title is Owner/clinician and has the following contact phone number (757) 818-4542.

The enumeration date for this NPI number is 11/8/2017 and was last updated on 11/13/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinicalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1010142768MEDICAIDVIRGINIA

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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