Provider Demographics
NPI:1417399247
Name:ESPINOZA, NICOLE JEAN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:JEAN
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:JEAN
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5341 W CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:IL
Mailing Address - Zip Code:60804-2817
Mailing Address - Country:US
Mailing Address - Phone:847-722-9657
Mailing Address - Fax:
Practice Address - Street 1:5341 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804-2817
Practice Address - Country:US
Practice Address - Phone:847-722-9657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker