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General NPI Number Information
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NPI Number | 1750741013
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Entity Type | Individual
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Provider Name | NICOLE FLANNERY MS, CSAC, LPC, ICS-I
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Gender | Female
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Dates
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Enumeration Date | 03/01/2016
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 217 WISCONSIN AVE STE 202
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City | WAUKESHA
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State | WI
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Zip | 53186-4946
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Country | US
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Telephone | 414-301-1518
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Fax |
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Provider Business Mailing Address
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Address Line | 2206 LANDER LN
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City | WAUKESHA
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State | WI
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Zip | 53188-4612
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Country | US
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Telephone | 414-232-7818
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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 | 15975-132
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License Number State | WI
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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 | 10001-125
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License Number State | WI
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