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General NPI Number Information
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NPI Number | 1396600839
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Entity Type | Individual
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Provider Name | NICOLE ANDREA HENRY
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 2807 N PARHAM RD STE 110
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City | RICHMOND
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State | VA
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Zip | 23294-4410
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Country | US
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Telephone | 804-418-3581
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Fax | 804-707-7020
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Provider Business Mailing Address
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Address Line | 2807 N PARHAM RD STE 110
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City | RICHMOND
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State | VA
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Zip | 23294-4410
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Country | US
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Telephone | 804-418-3581
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Fax | 804-707-7020
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701015612
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License Number State | VA
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