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General NPI Number Information
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NPI Number | 1922623495
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Entity Type | Individual
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Provider Name | NICOLE CHRISTINE TEPECIK LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 01/30/2021
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Provider Practice Location Address
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Address Line | 16135 PRESTON RD STE 209
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City | DALLAS
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State | TX
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Zip | 75248-8507
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Country | US
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Telephone | 214-814-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 16822 HUNTERS POINT DR
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City | DALLAS
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State | TX
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Zip | 75248-1616
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Country | US
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Telephone | 646-438-2277
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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 | 52047
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License Number State | TX
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