Provider Demographics
NPI:1053208751
Name:HEALTH CONCEPTS BEACON HEALTH
Entity type:Organization
Organization Name:HEALTH CONCEPTS BEACON HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TYNISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KADIRI
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:443-466-7500
Mailing Address - Street 1:1101 W PRATT ST STE 303
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21223-2693
Mailing Address - Country:US
Mailing Address - Phone:443-466-7500
Mailing Address - Fax:
Practice Address - Street 1:1101 W PRATT ST STE 303
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2693
Practice Address - Country:US
Practice Address - Phone:443-466-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No291U00000XLaboratoriesClinical Medical Laboratory
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty