Provider Demographics
NPI:1821369281
Name:NICOLE BAGGE LMHC INC.
Entity type:Organization
Organization Name:NICOLE BAGGE LMHC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAGGE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:561-254-7226
Mailing Address - Street 1:641 UNIVERSITY BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2791
Mailing Address - Country:US
Mailing Address - Phone:561-254-7226
Mailing Address - Fax:
Practice Address - Street 1:641 UNIVERSITY BLVD
Practice Address - Street 2:STE 206
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2791
Practice Address - Country:US
Practice Address - Phone:561-254-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9507261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health