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General NPI Number Information
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NPI Number | 1609912559
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Entity Type | Individual
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Provider Name | NICOLE HELENE GIES LCSW, RADC-I
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | N91W17271 APPLETON AVE
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2045
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Country | US
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Telephone | 262-502-3300
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Fax | 262-532-9585
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Provider Business Mailing Address
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Address Line | N91W17271 APPLETON AVE
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-2045
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Country | US
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Telephone | 262-502-3300
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Fax | 262-532-9585
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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 | 13989
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7319-123
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License Number State | WI
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