Provider Demographics
NPI:1962209668
Name:BARLOW, NICOLE (LAC, NCC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BARLOW
Suffix:
Gender:
Credentials:LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 GARFIELD AVE APT B
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3834
Mailing Address - Country:US
Mailing Address - Phone:518-605-1065
Mailing Address - Fax:
Practice Address - Street 1:57 HADDONFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4807
Practice Address - Country:US
Practice Address - Phone:609-889-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00731700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health