Provider Demographics
NPI:1669253050
Name:BATCHELDER, NICOLE (BA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BATCHELDER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 CUTHBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3417
Mailing Address - Country:US
Mailing Address - Phone:856-644-4977
Mailing Address - Fax:856-662-1202
Practice Address - Street 1:761 CUTHBERT BLVD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3417
Practice Address - Country:US
Practice Address - Phone:856-664-4977
Practice Address - Fax:856-662-1202
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2023-000434101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)