Healthcare Provider Details

I. General information

NPI: 1306568894
Provider Name (Legal Business Name): VICNIKOLSPEAKS: COUNSELING AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/11/2025
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MUIRS CHAPEL RD STE 322
GREENSBORO NC
27410-6173
US

IV. Provider business mailing address

4044 BATTLEGROUND AVE APT 3B
GREENSBORO NC
27410-9789
US

V. Phone/Fax

Practice location:
  • Phone: 336-543-0306
  • Fax:
Mailing address:
  • Phone: 252-315-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA NIKOL THOMPSON
Title or Position: OWNER
Credential: LCMHCA
Phone: 252-315-4442