Provider Demographics
NPI:1437699709
Name:SAMATE, NICOLE (MA, NCC, LPCC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SAMATE
Suffix:
Gender:F
Credentials:MA, NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14693 E 26TH WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-2410
Mailing Address - Country:US
Mailing Address - Phone:720-218-8927
Mailing Address - Fax:
Practice Address - Street 1:14693 E 26TH WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-2410
Practice Address - Country:US
Practice Address - Phone:720-218-8927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0014450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health