Individual provider · NPI-1

Nicole Azaan, CFMP, ACNSRSAPP

Psychologist, Cognitive & Behavioral · Jacksonville, NC

NPI number1437620986

StatusActive

Last updated in NPPESJun 22, 2026

Details

NPI: 1437620986
Entity type: Individual (NPI-1)
Name: Nicole Azaan
Credential: CFMP, ACNSRSAPP
Sex: Female
Sole proprietor: Yes
Enumeration date: Dec 10, 2018
Certification date: Jun 22, 2026
Last updated: Jun 22, 2026

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103TB0200X	Psychologist, Cognitive & Behavioral	AP-ETMD-2026-FA9CCS	NC	Yes
2084N0600X		AP-CNSR-2026-6T863R	NC
202D00000X	Integrative Medicine	AP-FMMD-2026-IC3W4T	NC
202D00000X	Integrative Medicine	AP-FMCC-2026-D21Z3N	NC
1744G0900X	Specialist, Graphics Designer	–	–

Practice location

2015 Gum Branch Rd Apt 405
Jacksonville, NC 28540-4601

Phone 646-450-1448 · Fax 208-978-5210

Mailing address

2015 Countrymens Ct Unit 51
Charlotte, NC 28210-6691

Phone 646-450-1448 · Fax 208-978-5210

Other practice locations

2015 Countrymens Ct Unit 51
Charlotte, NC 28210-6691

Phone 646-450-1448

1107 Hays Ln
Jacksonville, NC 28546-9347

Phone 646-450-1448

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