Provider Demographics
NPI:1033964655
Name:LAM, NICOLE A (LPC, CAADC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:LAM
Suffix:
Gender:F
Credentials:LPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2253
Mailing Address - Country:US
Mailing Address - Phone:717-380-8606
Mailing Address - Fax:
Practice Address - Street 1:2214 WOOD ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2253
Practice Address - Country:US
Practice Address - Phone:717-380-8606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016611101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional