Provider Demographics
NPI:1457396939
Name:BARTER, NICOLE (LMHC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BARTER
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 1:1620 MASSACHUSETTS AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-3826
Mailing Address - Country:US
Mailing Address - Phone:781-858-9570
Mailing Address - Fax:
Practice Address - Street 1:5 MIDDLESEX AVE
Practice Address - Street 2:STE 11, WILMINGTON FAMILY COUNSELING SERVICE INC
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887
Practice Address - Country:US
Practice Address - Phone:978-658-9889
Practice Address - Fax:978-658-5695
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5522101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health