Provider Demographics
NPI:1467682963
Name:DIAMOND, NICHOLE (LPC)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LINDSLEY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4455
Mailing Address - Country:US
Mailing Address - Phone:973-451-0246
Mailing Address - Fax:973-451-0166
Practice Address - Street 1:100 MADISON AVENUE
Practice Address - Street 2:CRISIS INTERVENTION
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-971-5402
Practice Address - Fax:973-971-5693
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00382600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional