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General NPI Number Information
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NPI Number | 1598459901
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Entity Type | Individual
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Provider Name | NICOLE ALEXANDRA TARRICONE LPC
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Gender | Female
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 820 S LATAH ST STE 110
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City | BOISE
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State | ID
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Zip | 83705-2239
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Country | US
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Telephone | 208-918-2441
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Fax |
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Provider Business Mailing Address
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Address Line | 3067 W FIELDSTREAM DR
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City | MERIDIAN
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State | ID
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Zip | 83646-4129
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Country | US
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Telephone | 305-761-8662
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-9532
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License Number State | ID
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