Healthcare Provider Details
I. General information
NPI: 1720709306
Provider Name (Legal Business Name): ARTOCIN PSYCHE' COUNSELING & CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2022
Last Update Date: 09/12/2022
Certification Date: 09/11/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1335 ELEMENT WAY APT 3209
WILMINGTON NC
28412-1612
US
IV. Provider business mailing address
1335 ELEMENT WAY APT 3209
WILMINGTON NC
28412-1612
US
V. Phone/Fax
- Phone: 856-803-0129
- Fax: 336-234-5030
- Phone: 856-803-0129
- Fax: 336-234-5030
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBYN
OLSEN-NICOTRA
Title or Position: PSYCHOTHERAPIST/OWNER
Credential: LCSW, PSY.D. (ABD)
Phone: 910-380-0885