MR. MIKE ALLEN BESWICK (NPI# 1164776589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164776589 |
| Entity Type | Individual |
| Full Name | MR. MIKE ALLEN BESWICK |
| Credential | LICSW |
| Practice Address |
34 Potomac Crossway Lewisburg WV 24901-8900 |
| Practice Telephone | 3044457790 |
| Mailing Telephone | 3046676423 |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | DP02943125 | WV | Residential Treatment Facilities |
| Street Address |
34 POTOMAC CROSSWAY |
| City | LEWISBURG |
| State | WV |
| Zip Code | 24901-8900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093940 | Amy Lu Moss | Technician | 254 Moss D Lane, Fairlea, WV 24901 | 2020-11-04 |
| 1083212377 | Miranda Shope | Technician | 814 Maple Ave., Lewisburg, WV 24901 | 2020-10-09 |
| 1184235830 | Carol E Beasley | Technician | 147 Windy Hill Road, Lewisburg, WV 24901 | 2020-08-14 |
| 1790317782 | Preston Dyer Modlin | Psychologist | 635 Church Street, Lewisburg, WV 24901 | 2020-02-07 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| 1821655390 | Janet Lee Kowalsky | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St., Lewisburg, WV 24901 | 2019-05-21 |
| 1598321192 | Ali Yousaf | Student in an Organized Health Care Education/Training Program | 400 North Jefferson, Lewisburg, WV 24901 | 2019-05-20 |
| 1770053308 | Micheala Renae Taylor | Student in an Organized Health Care Education/Training Program | 1464 North Jefferson Street, Lewisburg, WV 24901 | 2018-11-27 |
| 1659840486 | Maggie King Clendenen | Nurse Practitioner | 454 Bell Drive, Lewisburg, WV 24901 | 2018-11-22 |
| 1861979312 | Vincent Morra | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St, Lewisburg, WV 24901 | 2018-07-26 |
| Find all providers in zip 24901 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235354879 | Davis-stuart, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | Rr 2 Box 188a, Lewisburg, WV 24901-9320 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609383298 | Genesis Youth Crisis Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 413 Chestnut Street, Parsons, WV 26287 | 2018-01-04 |
| 1447622618 | The Children's Home Society of West Virginia, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 142 Cherry St, Daniels, WV 25832-9695 | 2015-10-27 |
| 1649664855 | Yale Academy LLC | Residential Treatment Facility, Emotionally Disturbed Children | 7 Crosswinds Dr, Fairmont, WV 26554-9193 | 2015-03-25 |
| 1366846016 | Family Connections, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 3305 Tent Church Road, Colliers, WV 26035 | 2014-10-09 |
| 1427470277 | Burlington United Methodist Family Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5162 Us 220 North, Moorefield, WV 26836 | 2014-01-14 |
| 1730320060 | Golden Girl, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 999 B Street, Ceredo, WV 25507-0876 | 2009-03-17 |
| 1295972248 | Yore Academy, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 7 Crosswind Drive, Fairmont, WV 26554 | 2009-01-13 |
| 1215199336 | Braley & Thompson, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 12 Clotine St, Saint Albans, WV 25177-2509 | 2008-06-30 |
| 1366602039 | Board of Child Care, Wv | Residential Treatment Facility, Emotionally Disturbed Children | 715 Brown Rd, Martinsburg, WV 25404-7282 | 2008-06-16 |
| 1104086503 | Charles W. Cammack Children's Center, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 64 6th Ave W, Huntington, WV 25701-1751 | 2008-06-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.