MEDICARE: NEKITA DANETTE BEACH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	A11347	NC
2	101YM0800X	Mental Health Counselor	11347	NC

General Provider Information

NPI Number	:	1376931899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEKITA DANETTE BEACH

Provider Business Mailing Address
First Line	:	5037 PLANTATION DR
Second Line	:
City	:	BATTLEBORO
State	:	NC
Zip	:	27809-8809
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7200 CREEDMOOR RD STE 200
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-1711
Country	:	US
Telephone Number	:	919-912-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2015
Last Update Date	:	09/15/2025

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Directions to “ NEKITA DANETTE BEACH ” Practice Location

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