Provider Demographics
NPI:1437513785
Name:HILLER, NICOLE BRIEL (LCPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:BRIEL
Last Name:HILLER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 STEEPLE CHASE CIR W
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-4822
Mailing Address - Country:US
Mailing Address - Phone:203-274-1249
Mailing Address - Fax:
Practice Address - Street 1:2360 STEEPLE CHASE CIR W
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-4822
Practice Address - Country:US
Practice Address - Phone:203-274-1249
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180012001101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional