Provider Demographics
NPI:1538628490
Name:NICOLE BAUER COUNSELING PLLC
Entity type:Organization
Organization Name:NICOLE BAUER COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DESTINY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:919-763-5258
Mailing Address - Street 1:1500 E ASH ST
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-5204
Mailing Address - Country:US
Mailing Address - Phone:919-617-7478
Mailing Address - Fax:
Practice Address - Street 1:1500 E ASH ST
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-5204
Practice Address - Country:US
Practice Address - Phone:919-617-7478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty