Nicole M Beagle, LBSW, LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301013447 Issued in MI

Practice address

217 E Sanilac Rd
Sandusky, MI 48471-1383

Phone

(810) 648-4327

Fax

(810) 648-4338

NPI assigned

Oct 10, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Sanilac County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Sandusky, MI
  • NPI 1306854880
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1467540294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 S FULTON ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711345",
            "telephone_number": "810-648-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711383",
            "telephone_number": "810-648-4327",
            "fax_number": "810-648-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAGLE",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LBSW, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802085142",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIMTD LICENSE MAST PSYCH.",
            "identifier": "6301013447",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LICENSE",
            "identifier": "6802085142",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Asthma, Allergy and Sinus Center, PC
• David M Baer, LMSW
• Taylor Ball
• Nicole Renee Bartels
• James T Bartley, BA, LBSW
• Megan Beals
• Janine Kay Beatty, MA, LBSW
• Kathleen M Behnke
• Harmony Elaine Bell
• Heather Benedict, MSN, RN, FNP-BC

• All providers in Sandusky, MI
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.