MEDICARE: NICHOLE COREY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YS0200X	School Counselor	PGP-0627809	VA

General Provider Information

NPI Number	:	1235090168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE COREY

Provider Business Mailing Address
First Line	:	3330 KING ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22302-3001
Country	:	US
Telephone Number	:	703-824-6750
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 KING ST
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22302-3001
Country	:	US
Telephone Number	:	703-824-6750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	11/25/2025

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Directions to “ NICHOLE COREY ” Practice Location

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