Healthcare Provider Details

I. General information

NPI: 1255122198
Provider Name (Legal Business Name): RYAN BEECHING COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3134 MALLARD COVE LN
FORT WAYNE IN
46804-2882
US

IV. Provider business mailing address

3134 MALLARD COVE LN
FORT WAYNE IN
46804-2882
US

V. Phone/Fax

Practice location:
  • Phone: 260-255-4770
  • Fax: 260-240-2191
Mailing address:
  • Phone: 260-255-4770
  • Fax: 260-240-2191

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: RYAN JOSEPH BEECHING
Title or Position: MEMBER
Credential: MA, LMHC
Phone: 260-519-3661