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General NPI Number Information
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NPI Number | 1679222624
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Entity Type | Individual
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Provider Name | NICOLE M KORTE LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 12 WINDING WAY
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City | SEA CLIFF
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State | NY
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Zip | 11579-1116
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Country | US
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Telephone | 917-620-4634
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Fax |
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Provider Business Mailing Address
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Address Line | 12 WINDING WAY
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City | SEA CLIFF
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State | NY
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Zip | 11579-1116
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Country | US
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Telephone | 917-620-4634
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 115773-01
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License Number State | NY
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