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1033728704 NPI number — NICHOLE M SLICK

NPI Number: 1033728704
Health Care Provider/Practitioner: NICHOLE M SLICK

Information about “1033728704” NPI (NICHOLE M SLICK) exists in 1033728704 in HTML format HTML  |  1033728704 in plain Text format TXT  |  1033728704 in PDF (Portable Document Format) PDF  |  1033728704 in an XML format XML  formats.

NPI Number : 1033728704 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033728704",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SLICK",
    "FirstName": "NICHOLE",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 778912",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60677-8912",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "317-777-6435",
    "MailingAddressFaxNumber": "317-777-6644",
    "FirstLinePracticeLocationAddress": "705 RILEY HOSPITAL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INDIANAPOLIS",
    "PracticeLocationAddressStateName": "IN",
    "PracticeLocationAddressPostalCode": "46202-5109",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "317-944-2143",
    "PracticeLocationAddressFaxNumber": "317-944-3107",
    "EnumerationDate": "07/28/2020",
    "LastUpdateDate": "09/23/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103TC2200X",
        "TaxonomyName": "Clinical Child & Adolescent Psychologist",
        "LicenseNumber": "20043904B",
        "LicenseNumberStateCode": "IN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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