Provider Demographics
NPI:1093416885
Name:KERN, NICOLE (LSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:KERN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:RHOADS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1721 RAMICH RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-9787
Mailing Address - Country:US
Mailing Address - Phone:484-651-4450
Mailing Address - Fax:
Practice Address - Street 1:1721 RAMICH RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-9787
Practice Address - Country:US
Practice Address - Phone:484-651-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134873104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker