Provider Demographics
NPI:1235926940
Name:BRIM, NICOLE (LMSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:BRIM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 WENTWORTH RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-7478
Mailing Address - Country:US
Mailing Address - Phone:443-674-3825
Mailing Address - Fax:
Practice Address - Street 1:9701 APOLLO DR STE 330
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-4795
Practice Address - Country:US
Practice Address - Phone:443-674-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29229104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker