Provider Demographics
NPI:1306332929
Name:GOLDIN-MURO, NICOLE (MMT, LAC, MT-BC, NMT)
Entity type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:
Last Name:GOLDIN-MURO
Suffix:
Gender:F
Credentials:MMT, LAC, MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4534 OWENS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1223
Mailing Address - Country:US
Mailing Address - Phone:504-234-2001
Mailing Address - Fax:
Practice Address - Street 1:2640 CANAL ST STE 4
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6448
Practice Address - Country:US
Practice Address - Phone:504-821-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4156101YA0400X
225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty