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General NPI Number Information
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NPI Number | 1801095013
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Entity Type | Individual
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Provider Name | ZOE A. NICHOLSON LMHC (EXPECTED 2011)
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Gender | Female
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 621 ROUTE 52
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City | BEACON
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State | NY
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Zip | 12508-1235
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Country | US
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Telephone | 845-522-9365
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BIRCH DR
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City | GREENWOOD LAKE
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State | NY
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Zip | 10925-2724
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Country | US
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Telephone | 201-895-4461
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P65338
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License Number State | NY
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