Provider Demographics
NPI:1104451657
Name:NEFOSKY, NICOLE (LMFT)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:NEFOSKY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:SCHELLINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:910 S CHAPEL ST STE 102
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3468
Mailing Address - Country:US
Mailing Address - Phone:302-224-1400
Mailing Address - Fax:
Practice Address - Street 1:300 BIDDLE AVE STE 207
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-3972
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEFT-0000061106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist