Provider Demographics
NPI:1285245324
Name:OSBORNE, NICOLE RENEE (LCMHC, LMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RENEE
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:LCMHC, LMHC, NCC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:RENEE
Other - Last Name:TOLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:524 KEAWE ST # 999
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3101
Mailing Address - Country:US
Mailing Address - Phone:808-207-6608
Mailing Address - Fax:
Practice Address - Street 1:1314 S KING ST STE 1055
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1945
Practice Address - Country:US
Practice Address - Phone:808-207-6608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health