Beverly Ann Sedlacek, APRN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4704276017 Issued in MI

Practice address

1850 Colfax Ave.
Benton Harbor, MI 49022-6753

Phone

(269) 926-6199

Fax

(269) 926-6780

NPI assigned

Jul 22, 2010

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1992018741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 COLFAX AVE.",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490226753",
            "telephone_number": "269-926-6199",
            "fax_number": "269-926-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 COLFAX AVE.",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490226753",
            "telephone_number": "269-926-6199",
            "fax_number": "269-926-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLACEK",
        "first_name": "BEVERLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "4704276017",
            "primary": true
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704276017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Benton Harbor, MI
• Providers in Benton Harbor, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.