Provider Demographics
NPI:1285015156
Name:FRITCH, NICOLE (MS,LMFT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:FRITCH
Suffix:
Gender:F
Credentials:MS,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 813
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6783
Mailing Address - Country:US
Mailing Address - Phone:386-547-5700
Mailing Address - Fax:
Practice Address - Street 1:700 S HARBOUR ISLAND BLVD UNIT 813
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-6783
Practice Address - Country:US
Practice Address - Phone:386-547-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2938101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health