Provider Demographics
NPI:1790716868
Name:WOFFORD, NICHOLE C (LMFT, MSW)
Entity Type:Individual
Prefix:MS
First Name:NICHOLE
Middle Name:C
Last Name:WOFFORD
Suffix:
Gender:F
Credentials:LMFT, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1981
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95759-1981
Mailing Address - Country:US
Mailing Address - Phone:916-733-2155
Mailing Address - Fax:916-686-9663
Practice Address - Street 1:1330 Q ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5705
Practice Address - Country:US
Practice Address - Phone:916-733-2155
Practice Address - Fax:916-686-9663
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 35159106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist