Psychiatry & Neurology, Psychiatry
BEACON MEDICAL GROUP, INC.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1629376645 · enumerated 2011-03-01 · record updated 2024-02-22. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: JEFFREY COSTELLO, VP/CFO · (574) 647-3549
Other names: BEACON MEDICAL GROUP BEHAVIORAL HEALTH SOUTH BEND
Addresses and phones
- Practice location 707 N MICHIGAN ST STE 400, SOUTH BEND, IN, 46601-1071 (574) 647-8470 Fax (574) 647-8475 Google Maps Apple Maps OpenStreetMap
- Mailing address 710 N NILES AVE, SOUTH BEND, IN, 46617-1924 (574) 647-1610 Google Maps Apple Maps OpenStreetMap
Specialties
- Nurse Practitioner, Psych/Mental Health 363LP0808X
- Family Medicine 207Q00000X
- Psychiatry & Neurology, Child & Adolescent Psychiatry 2084P0804X · License 01052982A IN
- 2084P0805X 2084P0805X · License 01052982A IN
- Psychiatry & Neurology, Psychiatry 2084P0800X · Primary · License 01052982A IN
In this directory
IN St. Joseph County South Bend Psychiatry & Neurology, Psychiatry
Locations and evidence
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Practice location
SOUTH BEND, IN, 466011071
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.