Provider Demographics
NPI:1477715795
Name:SCHWEON, NICOLE (LPC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SCHWEON
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 1:9254 MOSBY ST
Mailing Address - Street 2:#B
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5038
Mailing Address - Country:US
Mailing Address - Phone:571-358-9858
Mailing Address - Fax:888-509-0859
Practice Address - Street 1:9254 MOSBY ST
Practice Address - Street 2:#B
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5038
Practice Address - Country:US
Practice Address - Phone:571-358-9858
Practice Address - Fax:888-509-0859
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP 4021101YA0400X
FLMH 8923101YM0800X
NCNCC101YP2500X
VA0701005233101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health