Provider Demographics
NPI:1962981456
Name:BEIGHLE, NICOLE (LSCSW, LISW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BEIGHLE
Suffix:
Gender:F
Credentials:LSCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66505-0144
Mailing Address - Country:US
Mailing Address - Phone:785-553-9110
Mailing Address - Fax:
Practice Address - Street 1:104 S 4TH ST STE 204
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6957
Practice Address - Country:US
Practice Address - Phone:785-553-9110
Practice Address - Fax:785-553-9116
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHI.20024341041C0700X
KSLSCSW059121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health