Provider Demographics
NPI:1396392049
Name:OUTTEN, NICOLE KRISTINE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KRISTINE
Last Name:OUTTEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1821
Mailing Address - Country:US
Mailing Address - Phone:302-746-7265
Mailing Address - Fax:302-746-7343
Practice Address - Street 1:1307 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-1821
Practice Address - Country:US
Practice Address - Phone:302-746-7265
Practice Address - Fax:302-746-7343
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00017151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical