Provider Demographics
NPI:1669851762
Name:NICKEL, DIANNA (LPC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:NICKEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6440
Mailing Address - Country:US
Mailing Address - Phone:469-237-6100
Mailing Address - Fax:
Practice Address - Street 1:2620 LONG PRAIRIE RD STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4953
Practice Address - Country:US
Practice Address - Phone:817-240-0012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor