Provider Demographics
NPI:1033466917
Name:EUL, NICOLE M (LPC, SAC, LMHC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:EUL
Suffix:
Gender:F
Credentials:LPC, SAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 WALTON PL
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-5553
Mailing Address - Country:US
Mailing Address - Phone:920-217-3590
Mailing Address - Fax:
Practice Address - Street 1:610 WALTON PL
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-5553
Practice Address - Country:US
Practice Address - Phone:920-217-3590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61219035101YM0800X
WI15859-131101YA0400X
WI1686-226101YP2500X
WI16675-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH61219035OtherSTATE OF WASHINGTON DEPARTMENT OF HEALTH