Provider Demographics
NPI:1952994683
Name:GASKINS, NICOLE F (LPC-A, LCMHC-A)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:F
Last Name:GASKINS
Suffix:
Gender:F
Credentials:LPC-A, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 CHARLOTTE HWY STE 203
Mailing Address - Street 2:
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710-7062
Mailing Address - Country:US
Mailing Address - Phone:803-701-0212
Mailing Address - Fax:
Practice Address - Street 1:4341 CHARLOTTE HWY STE 203
Practice Address - Street 2:
Practice Address - City:LAKE WYLIE
Practice Address - State:SC
Practice Address - Zip Code:29710-7062
Practice Address - Country:US
Practice Address - Phone:803-701-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-13
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLPCA6539101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health