MEDICARE: DR. MINDY ARMBRUST BEACH IMFT-S, LPC

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	101YM0800X	Mental Health Counselor	C.1801411	OH
2	106H00000X	Marriage & Family Therapist	F.2200301-SUPV	OH

General Provider Information

NPI Number	:	1851801179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINDY ARMBRUST BEACH IMFT-S, LPC

Provider Business Mailing Address
First Line	:	4983 RIDGE RD
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-9738
Country	:	US
Telephone Number	:	330-485-3440
Fax Number	:

Provider Business Practice Location Address
First Line	:	4983 RIDGE RD
Second Line	:
City	:	WADSWORTH
State	:	OH
Zip	:	44281-9738
Country	:	US
Telephone Number	:	330-485-3440
Fax Number	:

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

Provider Enumeration Date	:	10/02/2017
Last Update Date	:	05/20/2023

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