Provider Demographics
NPI:1730618802
Name:HARRISON, NICOLE (MFT, LAC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MFT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 CIMARRON ST # 240
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-2250
Mailing Address - Country:US
Mailing Address - Phone:720-434-6972
Mailing Address - Fax:
Practice Address - Street 1:2101 S BLACKHAWK ST STE 240
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1475
Practice Address - Country:US
Practice Address - Phone:720-434-6972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-12
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.000771101YA0400X
COACD.0001296101YA0400X
CO13811101YM0800X
CO1942106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty