Beacon St. Psychiatry
NPI #1780460006 in Centerville, Ohio
Provider Information
- NPI Number
- 1780460006
- Entity Type
- Organization
- Organization Name
- Beacon St. Psychiatry
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Sep 1, 2023
- Last Updated
- Jan 24, 2024
Practice Location
- Address
- 10552 SUCCESS LN STE L
- City
- Centerville
- State
- Ohio
- ZIP Code
- 45458-3664
- Phone
- (937) 280-5711
Authorized Official
- Name
- MR. BRAD GIBSON, MBA, MSN, APRN
- Title
- CEO/OWNER
- Phone
- (937) 280-5711
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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