Individual provider Active NPI

Nicole A Bagge, LMHC

  • Mental Health Counselor
  • Palm Beach Gardens, FL
National Provider Identifier
1093958159
Registry record updated Apr 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH 9507 Issued in FL
Practice address
3307 Northlake Blvd
B104
Palm Beach Gardens, FL 33403-1703
Phone
(561) 254-7226
NPI assigned
Apr 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH 9507 FL Primary

Addresses

Primary practice location

3307 Northlake Blvd
B104
Palm Beach Gardens, FL 33403-1703

Mailing address

3307 Northlake Blvd
B104
Palm Beach Gardens, FL 33403-1703
Phone (561) 254-7226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH 9507FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1240099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240099200000",
    "number": "1093958159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 NORTHLAKE BLVD",
            "address_2": "B104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031703",
            "telephone_number": "561-254-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 NORTHLAKE BLVD",
            "address_2": "B104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031703",
            "telephone_number": "561-254-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGGE",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-19",
        "last_updated": "2009-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 9507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.