Provider Demographics
NPI:1457832438
Name:DEVONSHIRE, NICHOLE E (LCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:E
Last Name:DEVONSHIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 314
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47702-0314
Mailing Address - Country:US
Mailing Address - Phone:812-853-9110
Mailing Address - Fax:
Practice Address - Street 1:5000 S PLAZA DR
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-3066
Practice Address - Country:US
Practice Address - Phone:812-777-5230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical