Provider Demographics
NPI:1215146261
Name:MULHALL, NICOLE I (LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:I
Last Name:MULHALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:I
Other - Last Name:QUAIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:420 NORTH MAIN STREET
Mailing Address - Street 2:BRISTOL HOSPITAL, INC. DBA THE COUNSELING CENTER
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4923
Mailing Address - Country:US
Mailing Address - Phone:860-583-5858
Mailing Address - Fax:860-584-9962
Practice Address - Street 1:192 CAMPVILLE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06778-2218
Practice Address - Country:US
Practice Address - Phone:203-598-4707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical