Provider Demographics
NPI:1114363611
Name:PRESCOTT, NICOLE FRANCES (LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:FRANCES
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3S732 GLEN DR S
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3507
Mailing Address - Country:US
Mailing Address - Phone:630-885-3443
Mailing Address - Fax:
Practice Address - Street 1:3S732 GLEN DR S
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3507
Practice Address - Country:US
Practice Address - Phone:630-885-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-12
Last Update Date:2013-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.008982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health