Provider Demographics
NPI:1083954713
Name:ULM, NICOLE (IMF)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ULM
Suffix:
Gender:
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1571 GUILL RD
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-3737
Mailing Address - Country:US
Mailing Address - Phone:629-777-6241
Mailing Address - Fax:
Practice Address - Street 1:15261 LEBANON RD
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-1803
Practice Address - Country:US
Practice Address - Phone:629-777-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-16
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2679106H00000X
CAIMF 71489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist