Provider Demographics
NPI:1700390135
Name:DOYLE, NICOLE RENEE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:RENEE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34406 N 27TH DR STE 140
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-6079
Mailing Address - Country:US
Mailing Address - Phone:602-460-1920
Mailing Address - Fax:
Practice Address - Street 1:34406 N 27TH DR STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6079
Practice Address - Country:US
Practice Address - Phone:602-460-1920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ167121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical