Healthcare Provider Details

I. General information

NPI: 1255251773
Provider Name (Legal Business Name): NICOLE WALDEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 COLLEGE ST
WORCESTER MA
01610-2395
US

IV. Provider business mailing address

107 LASALLE ST
NEW BRITAIN CT
06051-1101
US

V. Phone/Fax

Practice location:
  • Phone: 508-793-3363
  • Fax: 508-793-3334
Mailing address:
  • Phone: 425-698-0307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: