Provider Demographics
NPI:1679222624
Name:KORTE, NICOLE M (LMSW)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:KORTE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:SEA CLIFF
Mailing Address - State:NY
Mailing Address - Zip Code:11579-1116
Mailing Address - Country:US
Mailing Address - Phone:917-620-4634
Mailing Address - Fax:
Practice Address - Street 1:12 WINDING WAY
Practice Address - Street 2:
Practice Address - City:SEA CLIFF
Practice Address - State:NY
Practice Address - Zip Code:11579-1116
Practice Address - Country:US
Practice Address - Phone:917-620-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115773-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical