Provider Demographics
NPI:1174007900
Name:MORREO, NICOLE (LP)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:MORREO
Suffix:
Gender:F
Credentials:LP
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:MORREO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LP
Mailing Address - Street 1:122 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6152
Mailing Address - Country:US
Mailing Address - Phone:401-451-0817
Mailing Address - Fax:
Practice Address - Street 1:400 MASSASOIT AVE
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-2012
Practice Address - Country:US
Practice Address - Phone:401-451-0817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10902103TC0700X
RIPS01993103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical