Beacon Mental And Wellness Center Limited Liability Company
Nurse Practitioner, Psych/Mental Health in Desoto, TX. Organization (NPI-2).
NPI number1336983709
StatusActive
Last updated in NPPESOct 30, 2025
Details
- NPI
- 1336983709
- Entity type
- Organization (NPI-2)
- Legal business name
- Beacon Mental And Wellness Center Limited Liability Company
- Organization subpart
- No
- Enumeration date
- Jun 20, 2024
- Certification date
- Oct 30, 2025
- Last updated
- Oct 30, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 251B00000X | Case Management | – | – | |
| 207Q00000X | Family Medicine | – | – | |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – |
Practice location
1534 N Hampton Rd Bldg CDesoto, TX 75115-2302
Phone 817-366-0950
Mailing address
1534 N Hampton Rd Ste CDesoto, TX 75115-2505
Phone 817-366-0950
Authorized official
Patrick Moneke
Ceo
8173660950
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