Provider Demographics
NPI:1346683265
Name:PARRA, NICOLE RENEE (M ED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:RENEE
Last Name:PARRA
Suffix:
Gender:F
Credentials:M ED, 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 PINK ROSE LN
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-6120
Mailing Address - Country:US
Mailing Address - Phone:610-704-8445
Mailing Address - Fax:
Practice Address - Street 1:961 MARCON BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9521
Practice Address - Country:US
Practice Address - Phone:610-266-0610
Practice Address - Fax:610-266-0292
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional