Provider Demographics
NPI:1407460694
Name:WORSECK, NICOLE (MA, C-AADC, LPCMH)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:WORSECK
Suffix:
Gender:F
Credentials:MA, C-AADC, LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 MOORING VIEW LN UNIT 1
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-9396
Mailing Address - Country:US
Mailing Address - Phone:484-347-9784
Mailing Address - Fax:
Practice Address - Street 1:20093 OFFICE CIR UNIT 207
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-3196
Practice Address - Country:US
Practice Address - Phone:302-856-9746
Practice Address - Fax:302-515-1992
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional