Provider Demographics
NPI:1336833094
Name:RAHUL, NICOLE ROSE (LPC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:ROSE
Last Name:RAHUL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:SINANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:99 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-5322
Mailing Address - Country:US
Mailing Address - Phone:973-819-4135
Mailing Address - Fax:
Practice Address - Street 1:99 PENN AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-5322
Practice Address - Country:US
Practice Address - Phone:973-819-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00611700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health