Provider Demographics
NPI:1215434337
Name:GIAMBRONE, NICOLE KRISTEN (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:KRISTEN
Last Name:GIAMBRONE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MADISON AVE # 10F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2820
Mailing Address - Country:US
Mailing Address - Phone:631-678-5360
Mailing Address - Fax:
Practice Address - Street 1:240 MADISON AVE # 10F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2820
Practice Address - Country:US
Practice Address - Phone:631-678-5360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010991101YM0800X, 101YM0800X
101YM0800X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program