=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740365774
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN R. NICOLAI LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 02/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 FREEPORT ST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77015-2310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-637-6000
-----------------------------------------------------
Fax | 713-637-6009
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 755 INTERNATIONAL BLVD SUITE 123
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77024-3589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-728-7181
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 18109
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------