Healthcare Provider Details

I. General information

NPI: 1134957863
Provider Name (Legal Business Name): NICOLETTE NAULT LMHC-D, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MYRTLE AVE
WESTPORT CT
06880-3511
US

IV. Provider business mailing address

8 MYRTLE AVE
WESTPORT CT
06880-3511
US

V. Phone/Fax

Practice location:
  • Phone: 203-908-5603
  • Fax:
Mailing address:
  • Phone: 203-908-5603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberD017270
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9481
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: