Beverly Gale Nicholas, MS, LPC, CADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5699 Issued in OK

Practice address

4001 N Classen Blvd
Ste 105
Oklahoma City, OK 73118-2685

Phone

(405) 524-2424

Fax

(405) 525-3677

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1629294970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 FREMONT DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731203909",
            "telephone_number": "405-838-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 N CLASSEN BLVD",
            "address_2": "STE 105",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731182685",
            "telephone_number": "405-524-2424",
            "fax_number": "405-525-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "BEVERLY",
        "middle_name": "GALE",
        "name_prefix": "Ms.",
        "credential": "MS, LPC, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "371",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OK",
            "license": "5699",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "5699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Marie Niblett, RADT, BHT, PRSS
• Tiffany M Nicar
• Jenette Louise Nicek
• Khalilah Ali Nichelson, M.ED., BHRS
• Nicholas J Schellati DDS PLLC
• Latanya D Nicholas
• Zachary Pearce Nicholas, M.D.
• Nichole Mentzer LCSW PLLC
• Tempie J Nichols-Rood, LCSW
• Allyson Nichols

• Professional Counselor in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Professional Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.