Healthcare Provider Details

I. General information

NPI: 1366581183
Provider Name (Legal Business Name): NICOLE ARCHER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 FARMINGTON AVE STE 207
WEST HARTFORD CT
06107-2184
US

IV. Provider business mailing address

998 FARMINGTON AVE STE 207
WEST HARTFORD CT
06107-2184
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-0170
  • Fax:
Mailing address:
  • Phone: 860-837-0170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: