Provider Demographics
NPI:1235869736
Name:HESS, NICOLE MARIE (LSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:MARIE
Last Name:HESS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 W CHESTNUT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-4188
Mailing Address - Country:US
Mailing Address - Phone:717-617-8123
Mailing Address - Fax:
Practice Address - Street 1:45 W BRANDT BLVD
Practice Address - Street 2:
Practice Address - City:SALUNGA
Practice Address - State:PA
Practice Address - Zip Code:17538-1105
Practice Address - Country:US
Practice Address - Phone:717-282-2908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA139228104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker