=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841117579
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BEACON HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/02/2026
-----------------------------------------------------
Last Update Date | 07/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 48 WOOD ST
-----------------------------------------------------
City | HOPKINTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01748-1106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-488-1315
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 68 HARRISON AVE STE 605 PMB 107572
-----------------------------------------------------
City | BOSTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02111-1929
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/THERAPIST
-----------------------------------------------------
Name | ELLEN HEDSTROM CLEGG
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 781-488-1315
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------