BEACON CLINIC INC. NPI 1194803734

NPI Information

  • NPI: 1194803734
  • Provider Name: BEACON CLINIC, INC.
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Organization
  • Former Legal Business Name: BEACON CLINIC
  • Address: 3821 TAMIAMI TRL # D
    PORT CHARLOTTE, FL
    ZIP 33952
  • Phone: (941) 629-7855

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NPI Details

BEACON CLINIC, INC. is a mental health counselor in Port Charlotte, FL. BEACON CLINIC, INC. NPI is 1194803734. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Beacon Clinic.

The provider's business location address is:

3821 TAMIAMI TRL # D
PORT CHARLOTTE, FL
ZIP 33952-377
Phone: (941) 629-7855
Fax: (941) 629-9589

The provider's authorized official is Noel E Holdsworth .
The authorized official title is Director and has the following contact phone number (941) 629-7855.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 8/22/2020.

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
1101YM0800XCounselorMental HealthNP2596452FLORIDAYes

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: 11/21/2025

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