BEACON THERAPY ASSOCIATES, PC – Marriage & Family Therapist, NPI 1407084031

BEACON THERAPY ASSOCIATES, PC is a healthcare provider. based in Roseville, Minnesota. specializing in Marriage & Family Therapist. The NPI Number for BEACON THERAPY ASSOCIATES, PC is 1407084031

Main info

Organization
Name
BEACON THERAPY ASSOCIATES, PC
NPI
1407084031
Phone
(763) 951-3091
Address
3101 Old Highway 8
Authorized Official
SHELLY MARIE DAVENPORT PRESIDENT/THERAPIST MS, LMFT
Enumeration Date
22 June 2009
Last Update Date
18 May 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience47
Completeness75
Years active:16State licenses:0Digital endpointsOther names

Provider Addresses for BEACON THERAPY ASSOCIATES, PC

  • 3101 Old Highway 8

    Roseville, MN 551131072

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Location

  • 700 Twelve Oaks Center Dr

    Wayzata, MN 553914401

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Location

  • 543 Coon Rapids Blvd NW

    Coon Rapids, MN 554335500

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Location

  • 299 Coon Rapids Blvd NW

    Coon Rapids, MN 554335832

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Location

  • 4501 Allendale Dr

    Saint Paul, MN 551276349

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Location

  • 11141, Zealand Avenue North, Champlin, Hennepin County, Minnesota, 55316, United States

    CHAMPLIN, MN 553163595

    Phone: (763) 951-3091

    Fax: (763) 951-3097

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-01-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-09-30 (983 days ago).

Enrollment records

1

Earliest due date

2023-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20130122000412OClinic/Group PracticeMN2023-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55113)

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Reviews

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Frequently asked questions

Where can patients find BEACON THERAPY ASSOCIATES, PC's NPI?
You can confirm BEACON THERAPY ASSOCIATES, PC with NPI 1407084031; it appears in the national provider directory.
Is BEACON THERAPY ASSOCIATES, PC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does BEACON THERAPY ASSOCIATES, PC list a primary specialty?
If you are matching referrals, note Marriage & Family Therapist for BEACON THERAPY ASSOCIATES, PC. Clinical services aligned with this taxonomy classification.
Does BEACON THERAPY ASSOCIATES, PC practice in Minnesota?
You will see Roseville, Minnesota on file for BEACON THERAPY ASSOCIATES, PC alongside any extra practice locations.
Is BEACON THERAPY ASSOCIATES, PC a real provider?
This page reflects official NPPES data for NPI 1407084031. Always confirm identity and privileges with the practice and licensing boards.

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