Provider Demographics
NPI:1508416793
Name:DUNSON, NICOLE (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:DUNSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2452 STATE ROUTE 9
Mailing Address - Street 2:STE 206
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-426-2801
Mailing Address - Fax:518-514-1383
Practice Address - Street 1:210 BALLSTON AVE
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-3606
Practice Address - Country:US
Practice Address - Phone:518-884-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-19
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health