Provider Demographics
NPI:1922762517
Name:DICKER, NICOLE ADLER (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ADLER
Last Name:DICKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 OXFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2235
Mailing Address - Country:US
Mailing Address - Phone:516-375-5238
Mailing Address - Fax:
Practice Address - Street 1:37 OXFORD BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2235
Practice Address - Country:US
Practice Address - Phone:516-375-5238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007880101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty