Provider Demographics
NPI:1821764655
Name:BEGLEY, KATHERINE CAROLYN III (MS)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:CAROLYN
Last Name:BEGLEY
Suffix:III
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14202 TREGARON RIDGE AVE APT C
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-4820
Mailing Address - Country:US
Mailing Address - Phone:402-321-9501
Mailing Address - Fax:
Practice Address - Street 1:14202 TREGARON RIDGE AVE APT C
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-4820
Practice Address - Country:US
Practice Address - Phone:402-321-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2805101YP2500X
NE3249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10028526800Medicaid