Healthcare Provider Details

I. General information

NPI: 1710605787
Provider Name (Legal Business Name): NICHOLE MARIE HUTCHINSON LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MORGAN BLVD
VALPARAISO IN
46383-4836
US

IV. Provider business mailing address

6107 HOLLISTER DR
INDIANAPOLIS IN
46224-3044
US

V. Phone/Fax

Practice location:
  • Phone: 195-251-7372
  • Fax:
Mailing address:
  • Phone: 317-748-7609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005386A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: