Provider Demographics
NPI:1578840997
Name:PARRA, NICHOLE LEE (LPC)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:LEE
Last Name:PARRA
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 1:523 A MT JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16102
Mailing Address - Country:US
Mailing Address - Phone:724-699-1543
Mailing Address - Fax:509-471-5742
Practice Address - Street 1:523 MT JACKSON RD.
Practice Address - Street 2:SUITE A
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16102
Practice Address - Country:US
Practice Address - Phone:724-699-1543
Practice Address - Fax:509-471-5742
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH8766101YM0800X
PAPC005793101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health