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General NPI Number Information
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NPI Number | 1407354962
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Entity Type | Individual
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Provider Name | NICOLE ELLIOTT LPC
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Gender | Female
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Dates
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Enumeration Date | 01/30/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 6250 US 62
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City | HILLSBORO
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State | OH
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Zip | 45133-7582
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Country | US
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Telephone | 937-393-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 13082 STRAIT CREEK RD
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City | PEEBLES
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State | OH
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Zip | 45660-9303
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Country | US
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Telephone | 937-515-9711
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.1500051
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License Number State | OH
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