Provider Demographics
NPI:1528463239
Name:ESHELMAN, NICOLE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:ESHELMAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 LITITZ PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3723
Mailing Address - Country:US
Mailing Address - Phone:717-315-4371
Mailing Address - Fax:833-946-3162
Practice Address - Street 1:2603 LITITZ PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3723
Practice Address - Country:US
Practice Address - Phone:717-315-4371
Practice Address - Fax:833-946-3162
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-24
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0212191041C0700X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty