Provider Demographics
NPI:1639365109
Name:SCHILD, NICOLE ANNE (LISW LCSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:ANNE
Last Name:SCHILD
Suffix:
Gender:F
Credentials:LISW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 DIXIE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FT WRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41011-2766
Mailing Address - Country:US
Mailing Address - Phone:859-578-4143
Mailing Address - Fax:
Practice Address - Street 1:1717 DIXIE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2766
Practice Address - Country:US
Practice Address - Phone:859-578-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical