Provider Demographics
NPI:1316649262
Name:WILSON, NICOLE MARIE HOYES (LICSW, LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE HOYES
Last Name:WILSON
Suffix:
Gender:F
Credentials:LICSW, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7919 S 112TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3231
Mailing Address - Country:US
Mailing Address - Phone:206-793-6002
Mailing Address - Fax:
Practice Address - Street 1:7919 S 112TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98178-3231
Practice Address - Country:US
Practice Address - Phone:206-793-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60953816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health