MEDICARE: NICCOLE MARIE JOYCE LPC

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	101YM0800X	Mental Health Counselor	PC009839	PA

General Provider Information

NPI Number	:	1215440680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICCOLE MARIE JOYCE LPC

Provider Business Mailing Address
First Line	:	1607 METHYL ST APT 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-3236
Country	:	US
Telephone Number	:	330-240-0193
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 METHYL ST APT 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-3236
Country	:	US
Telephone Number	:	330-240-0193
Fax Number	:

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

Provider Enumeration Date	:	11/08/2017
Last Update Date	:	11/08/2017

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