Provider Demographics
NPI:1669851762
Name:NICKEL, DIANNA (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:NICKEL
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8915 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-1717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3128 HUDSON XING STE 1
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-6556
Practice Address - Country:US
Practice Address - Phone:469-252-7090
Practice Address - Fax:469-617-7052
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor