Healthcare Provider Details

I. General information

NPI: 1801302559
Provider Name (Legal Business Name): NICOLE TURNER BEARDSLEE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N 37TH ST STE 301
NORFOLK NE
68701-3283
US

IV. Provider business mailing address

110 N 37TH ST STE 301
NORFOLK NE
68701-3283
US

V. Phone/Fax

Practice location:
  • Phone: 402-250-7925
  • Fax: 888-235-5956
Mailing address:
  • Phone: 402-250-7925
  • Fax: 888-861-8730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number4331
License Number StateNE

VIII. Authorized Official

Name: NICOLE TURNER BEARDSLEE
Title or Position: OWNER/THERAPIST
Credential: LIMHP LADC
Phone: 402-250-7925