Provider Demographics
NPI:1285460683
Name:NICHOLE PACIELLO LMHC LLC
Entity type:Organization
Organization Name:NICHOLE PACIELLO LMHC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER /FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:315-525-1409
Mailing Address - Street 1:2 RICHMOND SQ STE 105
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-5135
Mailing Address - Country:US
Mailing Address - Phone:315-525-1409
Mailing Address - Fax:401-216-6187
Practice Address - Street 1:2 RICHMOND SQ STE 105
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-5135
Practice Address - Country:US
Practice Address - Phone:315-525-1409
Practice Address - Fax:401-216-6187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty