Healthcare Provider Details

I. General information

NPI: 1316232085
Provider Name (Legal Business Name): NICOLE J. TURNER BEARDSLEE LIMHP LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 W OMAHA ST
CROFTON NE
68730-4150
US

IV. Provider business mailing address

11329 P ST STE 108
OMAHA NE
68137-2315
US

V. Phone/Fax

Practice location:
  • Phone: 402-649-6208
  • Fax: 888-649-3759
Mailing address:
  • Phone: 402-649-6208
  • Fax: 888-649-3759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2207
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1011
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH30770
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: