Provider Demographics
NPI:1629563101
Name:MARKO, NICOLE (LPCC-S, LICDC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MARKO
Suffix:
Gender:F
Credentials:LPCC-S, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20545 CENTER RIDGE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3423
Mailing Address - Country:US
Mailing Address - Phone:216-533-5113
Mailing Address - Fax:
Practice Address - Street 1:20545 CENTER RIDGE RD STE 305
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3423
Practice Address - Country:US
Practice Address - Phone:440-256-6573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health