Provider Demographics
NPI:1962247346
Name:ALLEN, NICHOLE MARIE (LPC, NCC, SCL)
Entity type:Individual
Prefix:MS
First Name:NICHOLE
Middle Name:MARIE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC, NCC, SCL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48306-4212
Mailing Address - Country:US
Mailing Address - Phone:248-760-9725
Mailing Address - Fax:
Practice Address - Street 1:1955 W HAMLIN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3338
Practice Address - Country:US
Practice Address - Phone:248-972-8882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222908101YM0800X
6401222908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health