Provider Demographics
NPI:1649638909
Name:AIKEN, NICHOLE HENNESSY (MED IN COUNSELING)
Entity type:Individual
Prefix:
First Name:NICHOLE
Middle Name:HENNESSY
Last Name:AIKEN
Suffix:
Gender:F
Credentials:MED IN COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25174 MINERAL SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-2566
Mailing Address - Country:US
Mailing Address - Phone:703-395-9135
Mailing Address - Fax:
Practice Address - Street 1:19 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3004
Practice Address - Country:US
Practice Address - Phone:571-367-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health