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General NPI Number Information
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NPI Number | 1609082254
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Entity Type | Individual
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Provider Name | NICOLE S DEEMS ED.S., LMFT, LAC
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/01/2019
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Provider Practice Location Address
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Address Line | 311 MEETZE AVE STE H
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City | LEXINGTON
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State | SC
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Zip | 29072-2625
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Country | US
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Telephone | 803-470-3786
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Fax |
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Provider Business Mailing Address
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Address Line | 306 DROOPING LEAF RD
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City | LEXINGTON
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State | SC
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Zip | 29072-6880
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Country | US
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Telephone | 803-600-2682
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1102249
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4518
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License Number State | SC
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