Provider Demographics
NPI:1609466614
Name:FROMAN, NICOLE SOPHIA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SOPHIA
Last Name:FROMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:SOPHIA
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4312 SHADOWBROOK CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3445
Mailing Address - Country:US
Mailing Address - Phone:970-420-8444
Mailing Address - Fax:
Practice Address - Street 1:4312 SHADOWBROOK CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-3445
Practice Address - Country:US
Practice Address - Phone:970-420-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099267881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical