Provider Demographics
NPI:1770038283
Name:BEACON COUNSELING, LLC
Entity Type:Organization
Organization Name:BEACON COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTONAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW, CDCA
Authorized Official - Phone:317-418-7370
Mailing Address - Street 1:8080 BECKETT CENTER DR
Mailing Address - Street 2:SUITE 326
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5026
Mailing Address - Country:US
Mailing Address - Phone:317-418-7370
Mailing Address - Fax:
Practice Address - Street 1:8080 BECKETT CENTER DR
Practice Address - Street 2:SUITE 326
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5026
Practice Address - Country:US
Practice Address - Phone:317-418-7370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.16002621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty