Provider Demographics
NPI:1407255904
Name:OSTROWSKI, NICOLE ELAINE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ELAINE
Last Name:OSTROWSKI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 RUTGER ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-3517
Mailing Address - Country:US
Mailing Address - Phone:314-534-6624
Mailing Address - Fax:314-535-4394
Practice Address - Street 1:932 RUTGER ST
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-3517
Practice Address - Country:US
Practice Address - Phone:314-534-6624
Practice Address - Fax:314-535-4394
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20130265401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical