MEDICARE: MS. NICOLE D PIPER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW9655	FL

General Provider Information

NPI Number	:	1053364356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE D PIPER LCSW

Provider Business Mailing Address
First Line	:	1512 GERALD AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-2324
Country	:	US
Telephone Number	:	239-368-0271
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 GERALD AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-2324
Country	:	US
Telephone Number	:	239-368-0271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/26/2011

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