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General NPI Number Information
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NPI Number | 1669317491
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Entity Type | Individual
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Provider Name | NICOLE FUSCALDO PHD, CRC, CVE, LCPC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 1333 BURR RIDGE PKWY STE 200
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City | BURR RIDGE
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State | IL
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Zip | 60527-0833
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Country | US
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Telephone | 815-762-7759
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 BURR RIDGE PKWY STE 200
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City | BURR RIDGE
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State | IL
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Zip | 60527-0833
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Country | US
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Telephone |
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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 | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 116441
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.014927
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License Number State | IL
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