| Beacon Behavioral Health Services | |
|
114 N Wood St Fremont OH 43420-2440 | |
| (567) 201-2048 | |
| (567) 280-4395 |
| Full Name | Beacon Behavioral Health Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 114 N Wood St, Fremont, Ohio |
| Authorized Official Name and Position | Melissa Ann Tester (OWNER/EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5672012048 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Behavioral Health Services 114 N Wood St Fremont OH 43420-2440 Ph: (567) 201-2048 | Beacon Behavioral Health Services 114 N Wood St Fremont OH 43420-2440 Ph: (567) 201-2048 |
| NPI Number | 1891374930 |
|---|---|
| Provider Enumeration Date | 04/06/2021 |
| Last Update Date | 04/06/2021 |
| Certification Date | 04/06/2021 |
| Medicare PECOS PAC ID | 4385033158 |
|---|---|
| Medicare Enrollment ID | O20211116002926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891374930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Melissa Ann Tester |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811191737 PECOS PAC ID: 5294124061 Enrollment ID: I20211116003002 |
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Beacon Behavioral Health Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 N Wood St, Fremont, OH 43420 Phone: 567-201-2048 Fax: 567-280-4395 |