Provider Demographics
NPI:1932479326
Name:RAMMELL, NICHOLE CHRISTENE (LCSW)
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:CHRISTENE
Last Name:RAMMELL
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 1:230 N 1680 E STE D1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2576
Mailing Address - Country:US
Mailing Address - Phone:435-705-9571
Mailing Address - Fax:435-922-0778
Practice Address - Street 1:230 N 1680 E STE D1
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2576
Practice Address - Country:US
Practice Address - Phone:435-705-9571
Practice Address - Fax:435-922-0778
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-03
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-156301041C0700X
NV9298-C1041C0700X
COCSW.099285861041C0700X
UT8761885-35011041C0700X
IDLCSW-331951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807126900Medicaid