Provider Demographics
NPI:1487360350
Name:FEEHAN, NICOLE (LCMHCA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FEEHAN
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PARK OFFICES DRIVE
Mailing Address - Street 2:PO BOX 13965
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709
Mailing Address - Country:US
Mailing Address - Phone:610-849-3031
Mailing Address - Fax:
Practice Address - Street 1:4 BAY RIDGE CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8108
Practice Address - Country:US
Practice Address - Phone:610-849-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA15973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health