Provider Demographics
NPI:1265612196
Name:SEEGARS, NICOLE (LPC, GCDF, NCC,)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:SEEGARS
Suffix:
Gender:F
Credentials:LPC, GCDF, NCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3718 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6235
Mailing Address - Country:US
Mailing Address - Phone:803-417-0983
Mailing Address - Fax:
Practice Address - Street 1:3718 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6235
Practice Address - Country:US
Practice Address - Phone:803-417-0983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4607101YS0200X
NC7057101YS0200X, 101YM0800X
SC5009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool