Provider Demographics
NPI:1104681980
Name:MCCOURT, NICOLE F (CADC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:F
Last Name:MCCOURT
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:F
Other - Last Name:TUSCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC
Mailing Address - Street 1:96 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04254-1511
Mailing Address - Country:US
Mailing Address - Phone:207-645-9770
Mailing Address - Fax:207-520-2373
Practice Address - Street 1:96 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIVERMORE FALLS
Practice Address - State:ME
Practice Address - Zip Code:04254-1511
Practice Address - Country:US
Practice Address - Phone:207-645-9770
Practice Address - Fax:207-520-2373
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC8435101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)