Provider Demographics
NPI:1619106150
Name:BEACON CHRISTIAN MINISTRIES
Entity Type:Organization
Organization Name:BEACON CHRISTIAN MINISTRIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LSW, LPCC-S
Authorized Official - Phone:330-201-4074
Mailing Address - Street 1:356 SCHOOL CT
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-2226
Mailing Address - Country:US
Mailing Address - Phone:330-201-4074
Mailing Address - Fax:
Practice Address - Street 1:633 KIEFFER ST
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2415
Practice Address - Country:US
Practice Address - Phone:330-201-4074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEACON COUNSELING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-06
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0003277-SUPV101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty