Healthcare Provider Details

I. General information

NPI: 1649198847
Provider Name (Legal Business Name): NICOLE NUTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE PECORARO

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHICAGO AVE STE 30
WESTMONT IL
60559-1756
US

IV. Provider business mailing address

675 ROCHELLE TER
LOMBARD IL
60148-1642
US

V. Phone/Fax

Practice location:
  • Phone: 630-481-4101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178023056
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: