Provider Demographics
NPI:1073227526
Name:LAYER, NICOLE ANGELA (MHC-LP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ANGELA
Last Name:LAYER
Suffix:
Gender:F
Credentials:MHC-LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 N ATLANTA AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-2005
Mailing Address - Country:US
Mailing Address - Phone:516-242-2824
Mailing Address - Fax:
Practice Address - Street 1:2222 FLATBUSH AVE UNIT 340152
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4530
Practice Address - Country:US
Practice Address - Phone:646-496-7777
Practice Address - Fax:718-513-4966
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health