Healthcare Provider Details

I. General information

NPI: 1447030002
Provider Name (Legal Business Name): NICOLE LEGER-STARBIRD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 COUNTRY CLUB BLVD
LITTLE EGG HARBOR TWP NJ
08087-1831
US

IV. Provider business mailing address

33 COUNTRY CLUB BLVD
LITTLE EGG HARBOR TWP NJ
08087-1831
US

V. Phone/Fax

Practice location:
  • Phone: 201-834-7327
  • Fax:
Mailing address:
  • Phone: 201-834-7327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01193400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: