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General NPI Number Information
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NPI Number | 1679247829
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Entity Type | Individual
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Provider Name | NINA NICHOLE BEAMISH
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Gender | Female
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 7000 BEE CAVES RD STE 325
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City | AUSTIN
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State | TX
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Zip | 78746-5009
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Country | US
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Telephone | 512-684-9909
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Fax |
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Provider Business Mailing Address
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Address Line | 350 MICA TRL
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City | MAXWELL
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State | TX
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Zip | 78656-2009
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Country | US
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Telephone | 630-877-0041
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 88308
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178.017119
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License Number State | IL
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