Healthcare Provider Details

I. General information

NPI: 1063829943
Provider Name (Legal Business Name): RYAN JOESPH BEECHING M.A. IN COUNSELING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2014
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 MAGNAVOX WAY
FORT WAYNE IN
46804-1565
US

IV. Provider business mailing address

6520 W 100 N
ANDREWS IN
46702-9428
US

V. Phone/Fax

Practice location:
  • Phone: 260-483-7207
  • Fax:
Mailing address:
  • Phone: 260-519-3661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: