Nicole Margaret Bereolos, PHD, MPH

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36061 Issued in TX

Practice address

5900 S Lake Forest Dr Ste 300
McKinney, TX 75070-2238

Phone

(972) 768-7994

Fax

(972) 692-0976

NPI assigned

May 18, 2011

Last updated

Sep 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicole Bereolos, PHD, PLLC

  • Psychologist
  • Dallas, TX
  • NPI 1184115313
  Authorized official Same address or phone

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1427341825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 COYOTE RUN",
            "city": "LUCAS",
            "state": "TX",
            "postal_code": "750028805",
            "telephone_number": "972-768-7994",
            "fax_number": "972-692-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 S LAKE FOREST DR STE 300",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750702238",
            "telephone_number": "972-768-7994",
            "fax_number": "972-692-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREOLOS",
        "first_name": "NICOLE",
        "middle_name": "MARGARET",
        "name_prefix": "Dr.",
        "credential": "PHD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-18",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01228",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam W Benham, DDS MS
• Lisset Karina Benitez, FNP
• Sandra Martin Benton, LCDC
• Farnaz Berahman
• Ellanie Berba, OTR
• Cathryn Renee Beresford, LPC
• Berg & Minigutti, PLLC
• Berg & Minigutti, PLLC (West McKinney Health and Wellness)
• Laura Elizabeth Bergmann
• Marvin Wade Berlin, DDS

• Clinical Psychologist in McKinney, TX
• Providers in McKinney, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.