Provider Demographics
NPI:1295151694
Name:BEIN, NANCY ELLEN (LCSW)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELLEN
Last Name:BEIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 CARAMBOLA CIR S
Mailing Address - Street 2:206
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-2302
Mailing Address - Country:US
Mailing Address - Phone:954-729-8490
Mailing Address - Fax:954-323-8614
Practice Address - Street 1:2767 CARAMBOLA CIR S
Practice Address - Street 2:206
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-2302
Practice Address - Country:US
Practice Address - Phone:954-729-8490
Practice Address - Fax:954-323-8614
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW11240101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health