Provider Demographics
NPI:1346052511
Name:VISNESKY, NICHOLE (RCSWI)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:VISNESKY
Suffix:
Gender:X
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 N OAKLAND FOREST DR APT 303
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33309-7616
Mailing Address - Country:US
Mailing Address - Phone:252-295-9325
Mailing Address - Fax:
Practice Address - Street 1:2820 N OAKLAND FOREST DR APT 303
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33309-7616
Practice Address - Country:US
Practice Address - Phone:561-501-1343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW183461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical