Provider Demographics
NPI:1619270071
Name:OPRINS, NICHOLE M (LCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:M
Last Name:OPRINS
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 1:6550 W EMERALD ST
Mailing Address - Street 2:STE 108
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8780
Mailing Address - Country:US
Mailing Address - Phone:208-342-6300
Mailing Address - Fax:
Practice Address - Street 1:6550 W EMERALD ST
Practice Address - Street 2:STE 108
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8780
Practice Address - Country:US
Practice Address - Phone:208-342-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW27633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health