Provider Demographics
NPI:1396112371
Name:WANZEK, NICOLE (LPCC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:WANZEK
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 13TH ST NE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-3586
Mailing Address - Country:US
Mailing Address - Phone:701-952-6655
Mailing Address - Fax:
Practice Address - Street 1:804 13TH ST NE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-3586
Practice Address - Country:US
Practice Address - Phone:701-952-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND844-8-1-15-340101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional