Provider Demographics
NPI:1114628005
Name:PARYZ, NICOLE (LCPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:PARYZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13007 SHANNON PARK LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-8015
Mailing Address - Country:US
Mailing Address - Phone:716-359-2087
Mailing Address - Fax:
Practice Address - Street 1:3854 N CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4103
Practice Address - Country:US
Practice Address - Phone:716-359-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008270101YP2500X
180.008270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional