Provider Demographics
NPI:1922424209
Name:SERINI, NICOLE MARIE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MARIE
Last Name:SERINI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:MARIE
Other - Last Name:SERINI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:37A BELL DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1607
Mailing Address - Country:US
Mailing Address - Phone:845-705-4790
Mailing Address - Fax:
Practice Address - Street 1:1334 RT 9W
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NY
Practice Address - Zip Code:12542
Practice Address - Country:US
Practice Address - Phone:845-705-4790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-11
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP92018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health