Provider Demographics
NPI:1740474378
Name:PRIOLEAU, NICOLE TIFFANY (LPC)
Entity type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:TIFFANY
Last Name:PRIOLEAU
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 1:4921 CORNELIA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2001
Mailing Address - Country:US
Mailing Address - Phone:843-568-2510
Mailing Address - Fax:
Practice Address - Street 1:4921 CORNELIA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-2001
Practice Address - Country:US
Practice Address - Phone:843-568-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health