Nicole Elise Anderson, LCSW
Counselor, Mental Health in Normal, IL. Individual provider (NPI-1).
NPI number1346900909
StatusActive
Last updated in NPPESDec 23, 2021
Details
- NPI
- 1346900909
- Entity type
- Individual (NPI-1)
- Name
- Nicole Elise Anderson
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 23, 2021
- Certification date
- Dec 23, 2021
- Last updated
- Dec 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 149.022401 | IL | Yes |
Practice location
1105 Market StNormal, IL 61761-3329
Phone 309-310-1629
Mailing address
1105 Market StNormal, IL 61761-3329
Phone 309-310-1629
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