Provider Demographics
NPI:1417323650
Name:REED, NICOLE R (LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:R
Last Name:REED
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:R
Other - Last Name:SKARLOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1905 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4904
Mailing Address - Country:US
Mailing Address - Phone:512-632-0483
Mailing Address - Fax:
Practice Address - Street 1:1905 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4904
Practice Address - Country:US
Practice Address - Phone:512-632-0483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60335101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health