Provider Demographics
NPI:1528681442
Name:DEPASQUALE, NICOLE (LPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DEPASQUALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08722-0043
Mailing Address - Country:US
Mailing Address - Phone:848-480-1731
Mailing Address - Fax:
Practice Address - Street 1:74 LOCKER ST
Practice Address - Street 2:#43
Practice Address - City:BEACHWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08722-0043
Practice Address - Country:US
Practice Address - Phone:848-480-1731
Practice Address - Fax:888-538-6164
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00718200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist