Provider Demographics
NPI:1326790841
Name:KANGLEY, NICOLE (MS LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:KANGLEY
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-7709
Mailing Address - Country:US
Mailing Address - Phone:201-741-5393
Mailing Address - Fax:
Practice Address - Street 1:1000C LAKE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1286
Practice Address - Country:US
Practice Address - Phone:201-689-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC0000399101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor