Healthcare Provider Details

I. General information

NPI: 1568126993
Provider Name (Legal Business Name): PATRICE NERONE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 CREEK TRAIL LN APT 402
CORNELIUS NC
28031-6552
US

IV. Provider business mailing address

14316 REESE BLVD W STE B-1692
HUNTERSVILLE NC
28078-7959
US

V. Phone/Fax

Practice location:
  • Phone: 312-884-9879
  • Fax:
Mailing address:
  • Phone: 312-884-9879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number494496
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.017624
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number267487
License Number StateOH
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.017310
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: