Provider Demographics
NPI:1487148896
Name:STARGELL, NICOLE A (LPCA, NCC)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:A
Last Name:STARGELL
Suffix:
Gender:F
Credentials:LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 E BESSEMER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6320
Mailing Address - Country:US
Mailing Address - Phone:336-542-2076
Mailing Address - Fax:336-272-1182
Practice Address - Street 1:208 E BESSEMER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6320
Practice Address - Country:US
Practice Address - Phone:336-542-2076
Practice Address - Fax:336-272-1182
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8848101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor