Healthcare Provider Details

I. General information

NPI: 1740924448
Provider Name (Legal Business Name): JAELIN A BEACHY PSYD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 CHARLES SNIDER RD
GOSHEN OH
45140-9588
US

IV. Provider business mailing address

424 WARDS CORNER RD STE 200
LOVELAND OH
45140-6966
US

V. Phone/Fax

Practice location:
  • Phone: 513-575-1444
  • Fax: 513-575-1451
Mailing address:
  • Phone: 513-576-7700
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.09020
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: