Provider Demographics
NPI:1629396148
Name:KRAUSE, NICOLE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:NICIOLI; WALTHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:1061 ARMISTEAD LN
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-2474
Mailing Address - Country:US
Mailing Address - Phone:847-354-5977
Mailing Address - Fax:
Practice Address - Street 1:1061 ARMISTEAD LN
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-2474
Practice Address - Country:US
Practice Address - Phone:847-354-5977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008657101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health