Healthcare Provider Details

I. General information

NPI: 1124774385
Provider Name (Legal Business Name): ANDREA DENISE HALE-NICHOLS NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2022
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 CHAPMAN RD
NEWARK DE
19702-5499
US

IV. Provider business mailing address

256 CHAPMAN RD
NEWARK DE
19702-5499
US

V. Phone/Fax

Practice location:
  • Phone: 302-292-1334
  • Fax:
Mailing address:
  • Phone: 302-292-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0011847
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-0011847
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: