Healthcare Provider Details

I. General information

NPI: 1174131171
Provider Name (Legal Business Name): NICOLE STELZER LMFT-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3233A BUSINESS PARK DR STE 304
STEVENS POINT WI
54482-8861
US

IV. Provider business mailing address

3233A BUSINESS PARK DR STE 304
STEVENS POINT WI
54482-8861
US

V. Phone/Fax

Practice location:
  • Phone: 800-681-2374
  • Fax:
Mailing address:
  • Phone: 800-681-2374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1464-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: