Nicole Brock, LPC
Counselor, Professional in Fayetteville, AR. Individual provider (NPI-1).
NPI number1669989158
StatusActive
Last updated in NPPESFeb 9, 2023
Details
- NPI
- 1669989158
- Entity type
- Individual (NPI-1)
- Name
- Nicole Brock
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 5, 2018
- Certification date
- Feb 9, 2023
- Last updated
- Feb 9, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – |
Practice location
60 W Sunbridge DrFayetteville, AR 72703-1822
Phone 479-695-1240 · Fax 479-750-4843
Mailing address
2400 S 48th StSpringdale, AR 72762-6683
Phone 479-750-2020 · Fax 479-750-4843
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